One in Five TAVI Patients Can Go Home the Same Day as Their Heart Valve Procedure

Transcatheter aortic valve implantation - TAVI - was introduced as an alternative to open-heart surgery for patients too old or too sick to survive the operating room. It has since expanded to younger, healthier patients because the procedure itself is remarkably compact: a catheter threaded through the femoral artery, a replacement valve crimped onto a balloon, a deployment that takes seconds, and the patient is done. No chest opened, no heart stopped, no weeks in recovery.

Given how minimally invasive the procedure has become, clinicians have been asking an obvious question: does a patient actually need to spend the night in hospital afterward? Next-day discharge has already become routine at many centers. A retrospective analysis from James Cook University Hospital in Middlesbrough, UK, presented at the EAPCI Summit 2026, takes the next step: same-day discharge for selected patients.

How the program works

The analysis covered all elective cases considered eligible for same-day discharge following transfemoral TAVI between June 2018 and December 2024 - a six-and-a-half-year period. Eligibility for same-day discharge required: no significant peripheral vascular disease, an existing pacemaker or normal baseline heart rhythm, and adequate home support including someone present during the first night.

Exclusion criteria were severe frailty, cognitive dysfunction, complex prescribing needs, or clinical instability. These criteria are notable for their focus on real-world safety factors - home support and cognitive function matter for post-procedure monitoring regardless of how smoothly the procedure itself went.

Of 790 total TAVI patients during the study period, 279 (35.3%) were deemed eligible for same-day discharge at their pre-procedure assessment. Of those, 160 patients (57.3%) actually left the hospital the same day. That means approximately 20% of all TAVI patients in this cohort went home the day of their procedure.

Why some eligible patients did not leave the same day

Among the 119 eligible patients who did not achieve same-day discharge, the most common reason was heart rhythm conduction abnormalities after the procedure (67.2% of cases), followed by vascular problems at the access site (10.9%). Both are established complications of TAVI that require monitoring and sometimes intervention before discharge is safe. The protocol was flexible enough to recognize those situations and keep patients overnight when needed.

Thirty-day outcomes compared

The mean age of same-day discharge patients was 80.4 years - a group that might not immediately seem like prime candidates for going home hours after a cardiac procedure. Forty percent were female.

Clinical records were analyzed to assess outcomes at 30 days. Mortality was 1.8% in the same-day discharge group and 0.8% among those initially considered eligible but who stayed at least one night. The difference was not statistically significant (p=0.472). Readmission rates were 4.4% versus 9.2% - also not significant (p=0.102) and actually lower in the same-day group, though that comparison is complicated by selection factors that likely influenced who was and was not discharged the same day.

"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," said Dr. Krishnarpan Chatterjee. "This is important for patients as it reduces the risk of complications linked to hospital stay, such as infection or delirium."

The limits of a retrospective study

This is a single-center, retrospective analysis without randomization. The patients who received same-day discharge were selected - they met specific clinical and social criteria that distinguished them from other TAVI patients. Any comparison between the same-day group and others is therefore comparing groups that were already clinically different before discharge decisions were made. This does not invalidate the safety signal, but it prevents strong causal conclusions.

The study also does not report patient-reported outcomes - whether same-day discharge patients recovered as comfortably at home as those who stayed overnight, or whether they or their caregivers experienced more anxiety or uncertainty in the first 24 hours. Those dimensions matter for patient experience even when 30-day clinical outcomes are comparable.

The researchers call for further studies on same-day discharge after TAVI to build a more rigorous evidence base for expanding the practice. No external funding was received for this study, and the lead author reports no disclosures related to the work.