Safety of same-day discharge after mitral transcatheter edge-to-edge repair

The safety of same-day discharge following mitral transcatheter edge-to-edge repair (M-TEER) in a nationwide setting remains unclear.

Using the administrative databases on Medicare fee-for-service beneficiaries, we identified patients aged 65-99 years undergoing elective M-TEER from 2016 to 2021 and who were discharged home on the same day or the next day after the procedure. We applied a linear probability model to examine the relationship between same-day discharge and patient outcomes, adjusting for patient demographics, underlying comorbidities, and hospital fixed effects (effectively comparing outcomes within the same hospital). The primary outcome was the composite of 30-day mortality and heart failure (HF) readmission.

Of the total of 12,048 patients, 137 (1.1%) patients were discharged on the same day as the procedure. We did not find a statistically significant difference in the risk of the primary outcome [same-day discharge versus next-day discharge; adjusted risk difference (aRD), -1.0% points (pp); 95% confidence interval (CI), -2.8 to +0.8]. Similarly, we did not find significant differences between the two groups in 30-day mortality (aRD, -0.6 pp.; 95% CI, -2.0 to +0.9) and HF readmission (aRD, -0.5 pp.; 95% CI, -1.6 to +0.6).

In this study, we did not find evidence that the risk of 30-day mortality and HF readmission differed between same-day discharge and next-day discharge following M-TEER. Further investigations are needed to clarify who warrants prolonged observation after the procedures.