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Risk Stratification and Clinical Pathways to Optimize Length of Stay After Transcatheter Aortic Valve Replacement
Abstract
Background Transcatheter aortic valve replacement (TAVR) program experience and advances present opportunities to introduce minimalist clinical pathways. The purpose of this study was to determine the safety and feasibility of preprocedural individualized risk stratification for general anaesthesia and transesophageal echocardiography (GA/TEE) or awake TAVR and the postprocedural standard or rapid discharge TAVR clinical pathways. Methods Standardized screening and multidisciplinary heart team consensus was used to evaluate individual periprocedural risk and requirements. Postprocedural clinical status and criteria guided the timing of discharge. We evaluated standardized TAVR outcomes and length of stay according to periprocedural practice and postprocedural trajectory. Results In 144 consecutive patients who underwent TAVR in 2013 (mean age, 82.0 ± 7.1 years; 38.2% women; mean Society of Thoracic Surgeons score, 6.5% ± 4.1%), 101 (69.1%) were assigned to the GA/TEE protocol, whereas 43 (29.9%) were assigned to the minimalist awake TAVR protocol. Irrespective of mode of anaesthesia, 94 (65.3%) patients were discharged within the standard time, whereas 50 (34.7%) patients were suitable for rapid discharge. Overall outcomes at 30 days were 2.1% mortality, 1.4% stroke, and 2.1% life-threatening bleeding. Median length of stay was shortest in the awake TAVR group (2 days; interquartile range [IQR], 1-3 days) and rapid discharge group (2 days; IQR, 1-2 days) and longer in the GA/TEE and standard discharge (3 days, IQR, 3-4 days) groups. Conclusions Excellent outcomes and decreased length of stay can be achieved with individualized risk stratification to select the optimal periprocedural practice and determine the timing of discharge. These findings should be further evaluated in a large long-term clinical study.
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Albumin <3.0 g/dL and prealbumin ≤20 mg/dL have been used as acute-phase markers to trigger nutritional supplementation within 1 week of surgery, although they are not good markers of nutritional status.
“Although not good markers of nutritional status, albumin <3.0 g/dL and prealbumin ≤20 mg/dL have been used as acute-phase markers to trigger nutritional supplementation within 1 week of surgery.186,189–191”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [190]
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2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease
Nishimura, R. A., Otto, C. M., Bonow, R. O., Carabello, B. A., Erwin, J. P., Guyton, R. A., O’Gara, P. T., Ruiz, C. E., Skubas, N. J., Sorajja, P., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.02.536 · Cited by 3,523
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Research works printed but not linked: 25
- Leon, 2010, Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery, N Engl J Med, 363, 1597, 10.1056/NEJMoa1008232 · DOI · Paper page
- Adams, 2014, Transcatheter aortic-valve replacement with a self-expanding prosthesis, N Engl J Med, 370, 1790, 10.1056/NEJMoa1400590 · DOI · Paper page
- Smith, 2011, Transcatheter versus surgical aortic-valve replacement in high-risk patients, N Engl J Med, 364, 2187, 10.1056/NEJMoa1103510 · DOI · Paper page
- Leon, 2014, Challenges and future opportunities for transcatheter aortic valve therapy, Prog Cardiovasc Dis, 56, 635, 10.1016/j.pcad.2014.03.004 · DOI
- Davies, 2014, European experience and perspectives on transcatheter aortic valve replacement, Prog Cardiovasc Dis, 56, 625, 10.1016/j.pcad.2014.02.002 · DOI
- Toggweiler, 2013, 5-year outcome after transcatheter aortic valve implantation, J Am Coll Cardiol, 61, 413, 10.1016/j.jacc.2012.11.010 · DOI
- Lauck, 2013, Implementation of processes of care to support transcatheter aortic valve replacement programs, Eur J Cardiovasc Nurs, 12, 33, 10.1016/j.ejcnurse.2011.06.005 · DOI
- Hawkey MC, Lauck SB, Perpetua E, et al. Transcatheter aortic valve replacement program development: recommendations for best practice [epub ahead of print]. Catheter Cardiovasc Interv http://dx.doi.org/10.1002/ccd.25529, accessed July 3, 2014. · DOI
- Binder, 2013, The impact of integration of a multidetector computed tomography annulus area sizing algorithm on outcomes of transcatheter aortic valve replacement: a prospective, multicenter, controlled trial, J Am Coll Cardiol, 62, 431, 10.1016/j.jacc.2013.04.036 · DOI
- Frohlich, 2014, Local versus general anesthesia for transcatheter aortic valve implantation (TAVR): systematic review and meta-analysis, BMC Med, 12, 41, 10.1186/1741-7015-12-41 · DOI
- Zhu, 2012, Fast-track cardiac care for adult cardiac surgical patients, Cochrane Database Syst Rev, 10, CD003587
- Aziz, 2012, Implementing a pathway for the management of acute coronary syndrome leads to improved compliance with guidelines and a decrease in angina symptoms, J Healthc Qual, 34, 5, 10.1111/j.1945-1474.2011.00145.x · DOI
- Erkapic, 2012, Risk for permanent pacemaker after transcatheter aortic valve implantation: a comprehensive analysis of the literature, J Cardiovasc Electrophysiol, 23, 391, 10.1111/j.1540-8167.2011.02211.x · DOI
- Colli, 2014, National trends in hospitalization from indwelling urinary catheter complications, 2001-2010, Int Urol Nephrol, 46, 303, 10.1007/s11255-013-0524-x · DOI
- Saint, 2013, Preventing catheter-associated urinary tract infection in the United States: a national comparative study, JAMA Intern Med, 173, 874, 10.1001/jamainternmed.2013.101 · DOI
- Durand, 2012, Transfemoral aortic valve replacement with the Edwards SAPIEN and Edwards SAPIEN XT prosthesis using exclusively local anesthesia and fluoroscopic guidance: feasibility and 30-day outcomes, JACC Cardiovasc Interv, 5, 461, 10.1016/j.jcin.2012.01.018 · DOI
- Saxena, 2009, Delirium in the elderly: a clinical review, Postgrad Med J, 85, 405, 10.1136/pgmj.2008.072025 · DOI
- Steagall, 2013, Post-operative urinary retention, Nurs Stand, 28, 43, 10.7748/ns2013.10.28.5.43.e7926 · DOI
- Popp, 2012, Prevention and treatment options for postoperative delirium in the elderly, Curr Opin Psychiatry, 25, 515, 10.1097/YCO.0b013e328357f51c · DOI
- VanSuch, 2006, Effect of discharge instructions on readmission of hospitalised patients with heart failure: do all of the Joint Commission on Accreditation of Healthcare Organizations heart failure core measures reflect better care?, Qual Saf Health Care, 15, 414, 10.1136/qshc.2005.017640 · DOI
- Kappetein, 2012, Updated standardized endpoint definitions for transcatheter aortic valve implantation: Valve Academic Research Consortium-2 consensus document, J Am Coll Cardiol, 60, 1438, 10.1016/j.jacc.2012.09.001 · DOI
- Webb, 2012, Transcatheter aortic valve implantation: a Canadian Cardiovascular Society Position Statement, Can J Cardiol, 28, 520, 10.1016/j.cjca.2012.04.015 · DOI
- Taylor, 2012, ESC/EACTS guidelines on the management of valvular heart disease, Eur Heart J, 33, 2371
- Webb, 2012, Current status of transcatheter aortic valve replacement, J Am Coll Cardiol, 60, 483, 10.1016/j.jacc.2012.01.071 · DOI
- Arnold, 2014, Predictors of poor outcomes after transcatheter aortic valve replacement: results from the PARTNER (Placement of Aortic Transcatheter Valve) trial, Circulation, 129, 2682, 10.1161/CIRCULATIONAHA.113.007477 · DOI
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Vest, A. R., DiDomenico, R. J., Lichtenstein, L., Slater, T., Ekpo, E., Damluji, A. A., Bohula, E., Alviar, C. L., on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology, & Council on Cardiovascular and Stroke Nursing (2026) · Circulation · doi:10.1161/cir.0000000000001405 · Cited by 15
Metadata
- Authors
- Lauck, S. B., Wood, D. A., Achtem, L., Baumbusch, J., Boone, R. H., Cheung, A., Dvir, D., Stub, D., Tan, J. S., Ye, J., & Webb, J. G.
- Affiliations
- University of British Columbia (CA)
- St. Paul's Hospital (CA)
- Corresponding author
- Lauck, Sandra B.
- ORCID
- Venue
- Canadian Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 30
- Issue
- 12
- Pages
- 1583-1587
- ISSN
- 0828-282X (ISSN-L)
- OpenAlex
- W1991284756
- Cited by
- 40
- References
- 1
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 8 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 7 · 2015: 3
- FWCI
- 3.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Canadian Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Infective Endocarditis Diagnosis and Management
- Keywords
- transcatheter aortic valve implantation, length of hospital stay, risk stratification, care pathways, general anesthesia, transesophageal echocardiography, rapid discharge, periprocedural risk, heart team, post-procedural outcomes
- MeSH terms
- Aged, 80 and over, Aortic Valve Stenosis, British Columbia, Female, Follow-Up Studies, Cardiac Catheterization, Heart Valve Prosthesis, Humans, Length of Stay, Male, Severity of Illness Index, Tomography, X-Ray Computed, Treatment Outcome, Hospital Mortality, Echocardiography, Transesophageal, Risk Assessment, Critical Pathways, Kaplan-Meier Estimate, Transcatheter Aortic Valve Replacement
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