TY - JOUR
T1 - Safety and feasibility of early discharge after transcatheter aortic valve implantation with ACURATE Neo—the POLESTAR trial
AU - Ooms, Joris F.
AU - Cornelis, Kristoff
AU - Wijeysundera, Harindra C.
AU - Vandeloo, Bert
AU - Van Der Heyden, Jan
AU - Kovac, Jan
AU - Wood, David
AU - Chan, Albert
AU - Wykyrzykowska, Joanna
AU - Rosseel, Liesbeth
AU - Cunnington, Michael
AU - van der Kley, Frank
AU - Rensing, Benno
AU - Voskuil, Michiel
AU - Hildick-Smith, David
AU - Van Mieghem, Nicolas M.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2025
Y1 - 2025
N2 - Background: Transcatheter aortic valve implantation (TAVI) serves a growing range of patients with severe aortic stenosis (AS). TAVI has evolved to a streamlined procedure minimizing length of hospital stay. Aims: To evaluate the safety and efficacy of an early discharge (ED) strategy after TAVI.Methods: We performed an international, multi-center, prospective observational single-arm study in AS patients undergoing TAVI with the ACURATE valve platform. Eligibility for ED was assessed prior to TAVI and based on prespecified selection criteria. Discharge ≤ 48 h was defined as ED. Primary Valve Academic Research Consortium (VARC)-3-defined 30-day safety and efficacy composite endpoints were landmarked at 48 h and compared between ED and non-ED groups. Results: A total of 252 patients were included. The median age was 82 [25th–75th percentile, 78–85] years and the median Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score was 2.2% [25th–75th percentile, 1.6–3.3]. ED and non-ED were achieved in 173 (69%) and 79 (31%) patients respectively. Monitoring for conduction disturbances was the principal reason for non-ED (33%). Overall, at 30 days, all-cause mortality was 1%, new permanent pacemaker rate was 4%, and valve- or procedure-related rehospitalization was 4%. There was no difference in the primary safety and efficacy endpoint between the ED and non-ED cohorts (OR 0.84 [25th–75th percentile, 0.31–2.26], p = 0.73, and OR 0.97 [25th–75th percentile, 0.46–2.06], p = 0.94). The need for rehospitalization was similarly low for ED and non-ED groups. Conclusion: Early discharge after TAVI with the ACURATE valve is safe and feasible in selected patients. Rhythm monitoring and extended clinical observation protracted hospital stay. Graphical Abstract: Safety and feasibility of early discharge after transcatheter aortic valve implantation with ACURATE Neo, an international multi-center, prospective observational single-arm study. OR, odds ratio (95% confidence interval); VARC, Valve Academic Research Consortium (Figure presented.).
AB - Background: Transcatheter aortic valve implantation (TAVI) serves a growing range of patients with severe aortic stenosis (AS). TAVI has evolved to a streamlined procedure minimizing length of hospital stay. Aims: To evaluate the safety and efficacy of an early discharge (ED) strategy after TAVI.Methods: We performed an international, multi-center, prospective observational single-arm study in AS patients undergoing TAVI with the ACURATE valve platform. Eligibility for ED was assessed prior to TAVI and based on prespecified selection criteria. Discharge ≤ 48 h was defined as ED. Primary Valve Academic Research Consortium (VARC)-3-defined 30-day safety and efficacy composite endpoints were landmarked at 48 h and compared between ED and non-ED groups. Results: A total of 252 patients were included. The median age was 82 [25th–75th percentile, 78–85] years and the median Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score was 2.2% [25th–75th percentile, 1.6–3.3]. ED and non-ED were achieved in 173 (69%) and 79 (31%) patients respectively. Monitoring for conduction disturbances was the principal reason for non-ED (33%). Overall, at 30 days, all-cause mortality was 1%, new permanent pacemaker rate was 4%, and valve- or procedure-related rehospitalization was 4%. There was no difference in the primary safety and efficacy endpoint between the ED and non-ED cohorts (OR 0.84 [25th–75th percentile, 0.31–2.26], p = 0.73, and OR 0.97 [25th–75th percentile, 0.46–2.06], p = 0.94). The need for rehospitalization was similarly low for ED and non-ED groups. Conclusion: Early discharge after TAVI with the ACURATE valve is safe and feasible in selected patients. Rhythm monitoring and extended clinical observation protracted hospital stay. Graphical Abstract: Safety and feasibility of early discharge after transcatheter aortic valve implantation with ACURATE Neo, an international multi-center, prospective observational single-arm study. OR, odds ratio (95% confidence interval); VARC, Valve Academic Research Consortium (Figure presented.).
KW - Early discharge
KW - Self-expanding valve
KW - TAVI
UR - https://www.scopus.com/pages/publications/85190387339
U2 - 10.1007/s00392-024-02436-z
DO - 10.1007/s00392-024-02436-z
M3 - Article
AN - SCOPUS:85190387339
SN - 1861-0684
VL - 114
SP - 341
EP - 349
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
ER -