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Copyright ©The Author(s) 2022.
World J Cardiol. May 26, 2022; 14(5): 271-281
Published online May 26, 2022. doi: 10.4330/wjc.v14.i5.271
Table 1 Proposed pre-requisites for same day discharge in structural cardiac procedures
Pre-procedure
Administrative buy-in
Experienced operator
Same day discharge multi-disciplinary team including social workers and nursing
Elective procedure
Reliable means for follow-up
Patient without significant co-morbidities
Willing to depart on the same day
Adequate social support
During procedure
Intra-Procedural monitoring without significant hemodynamic compromise
Successful vascular access without immediate complications
Successful deployment of device
Right atrial pacing for TAVR without wenkebach
Post-procedure
Hemodynamic monitoring for 4-6 h without instability
Able to mobilize without assistance
Vascular access site integrity
TTE without significant pericardial effusion
No new AV block or inter-ventricular conduction delays
Prescriptions arranged
Evening phone call from provider
Next day in-person follow up for imaging and laboratory investigations
Table 2 Summary of Studies with same day discharges for structural heart disease procedures
Ref.
Year
Procedure
Same day discharge, nOutcome
Gilhofer et al[13]2020LAAO24No significant difference in overall events between SDD and non SDD
Tan et al[14]2021LAAO72No significant difference in 7 and 45 d outcomes between SDD and non SDD
Marmagkiolis et al[15]2021LAAO112No complications among patients that underwent SDD
Williams et al[16]2018LAAO781 patient from the SDD group was readmitted within 7 d
Marmagkiolis et al[24]2021Mitra-clip82No intra-procedure complications, only 1 patient had minor access site hematoma
Chen et al[25]2020Mitra-clip1No post procedure complication
Perdoncin et al[6]2021TAVR29No in hospital complications, no 30 d deaths
Russo et al[31]2020TAVR3No deaths or re-admissions within 24 d of procedure
Rai et al[32]2021TAVR6No immediate complications or events on 7 d rhythm monitor
Ponnuthurai et al[44]2009PFO/ASD48One Patient with groin hematoma immediately after procedure
Barker et al[45]2020PFO/ASD455No significant difference in death, 30 d readmission, device thrombosis, and stroke/TIA