Study supports safe same-day discharge following TAVI procedures

With careful selection, same-day hospital discharge was found to be feasible and safe in around one-fifth of patients undergoing transcatheter aortic valve implantation in a study presented today at the EAPCI Summit 2026. The summit is a new event organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), an association of the European Society of Cardiology (ESC).

Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure that is used to treat narrowing of the aortic valve (aortic stenosis). TAVI involves inserting a replacement valve on top of the old one via a catheter, usually from the groin. The procedure was initially developed as an alternative to open heart surgery for older patients and those at high risk of surgical complications; however, it is now commonly used even in people at lower risk of complications.

Presenter, Doctor Krishnarpan Chatterjee from the James Cook University Hospital, Middlesbrough, UK, explained the rationale for the analysis: "Next-day discharge after TAVI has become increasingly popular with advances in technology and streamlining of care pathways. Same-day discharge is the next step – this has been shown to be safe in a highly selected cohort of patients. At our centre, we have used a protocol with expanded inclusion criteria for same-day discharge after elective transfemoral day-case TAVI. Our day-case TAVI practice involves patients being admitted on the morning of the procedure and being discharged home the same day. We were able to demonstrate the safety of this approach in the presented analysis."

A retrospective analysis was performed of all elective cases identified as eligible for same-day discharge following elective day-case transfemoral TAVI between June 2018 and December 2024. Eligibility criteria for same-day discharge included no significant peripheral vascular disease, an existing pacemaker or normal baseline heart rhythm, and adequate home support including supervision by a relative/friend/carer during the first night. Exclusion criteria included severe frailty, cognitive dysfunction, complex prescribing needs or clinical instability.

Of 790 patients who underwent elective transfemoral TAVI during the study period, 279 patients (35.3%) were deemed eligible for potential same-day discharge at preassessment screening and 160 of these patients (57.3%) underwent successful same-day discharge. Reasons that patients were not successfully discharged on the same day included heart rhythm conduction abnormalities (67.2%) and vascular problems (10.9%). Clinical records were retrospectively analysed to assess 30-day outcomes.

The mean age of patients who underwent same-day discharge was 80.4 years and 40% were female.

Clinical outcomes between discharge and 30 days were similar in those who underwent successful same-day discharge and those initially considered potentially eligible for same-day discharge, but who stayed in for one night or longer. Mortality rates after 30 days were 1.8% in the same-day discharge group and 0.8% in the non-same-day discharge group (p=0.472). Readmission rates after 30 days were 4.4% for same-day discharge and 9.2% for non-same-day discharge (p=0.102).

With careful selection, we have shown that around 1 in 5 patients can be successfully discharged on the same day as their day-case TAVI procedures, without increased risk of adverse outcomes. This is important for patients as it reduces the risk of complications linked to hospital stay, such as infection or delirium. It is also associated with reduced use of healthcare resources. Further studies on same-day discharge after day-case TAVI are warranted."

Doctor Krishnarpan Chatterjee,  James Cook University Hospital, Middlesbrough, UK