Heart and Vessels最新文献

{"title":"Characteristics of cardiac rehabilitation progress during hospitalization and in-hospital outcomes after mitral transcatheter edge-to-edge repair.","authors":"Kentaro Hori, Atsuko Nakayama, Shinya Tajima, Ruka Kanazawa, Kotaro Hirakawa, Yuichi Adachi, Yuki Izumi, Ryosuke Higuchi, Itaru Takamisawa, Mamoru Nanasato, Mitsuaki Isobe","doi":"10.1007/s00380-025-02544-4","DOIUrl":"10.1007/s00380-025-02544-4","url":null,"abstract":"<p><p>Mitral regurgitation is a prevalent cardiac valvular disease, and its incidence is increasing with the aging population. While surgical intervention has traditionally been the standard treatment for this disease, in Japan, mitral transcatheter edge-to-edge repair (M-TEER) has emerged as a less invasive alternative since 2018. M-TEER demonstrates promising outcomes in reducing postoperative complications and shortening hospital stays. However, scarce data on cardiac rehabilitation (CR) following M-TEER is available. Therefore, in this study, we aimed to investigate the characteristics of CR progress during hospitalization and in-hospital outcomes following M-TEER. This single-center, retrospective cohort study involved 244 patients who underwent M-TEER at the Sakakibara Heart Institute between April 2018 and March 2023. Data on progress in CR and in-hospital outcomes, including hospitalization-associated disability (HAD), rate of return to home, and hospitalization that extended beyond 30 days after M-TEER, were collected. After excluding patients who met the exclusion criteria-including conversion to surgical mitral valve replacement or the absence of CR during hospitalization-233 patients were included in the analysis. The patients' median age was 81 years, with 48.5% being female. In 43% of cases, the hospitalizations were unplanned. Ambulation was initiated at a median of 1 day after M-TEER, with 88.4% of patients being able to commence ambulation as early as 2 days after M-TEER. However, only 19.3% engaged in aerobic exercise using equipment in the CR room. The median length of stay following M-TEER was 6 days, with 4.7% of hospitalizations resulting in a stay of 30 days or more. Ultimately, 90.6% of patients were discharged home, with an incidence of HAD of 9.9%. Compared to the planned hospitalization group, the unplanned hospitalization group had a significantly lower rate of early postoperative ambulation (planned hospitalization group: 97.7% vs. unplanned hospitalization group: 76.2%, p < 0.01), a higher proportion of patients with hospital stays exceeding 30 days (0% vs. 10.9%, p < 0.01), a lower rate of home discharge (98.5% vs. 80.2%, p < 0.01), and an increased incidence of HAD (0.8% vs. 22.2%, p < 0.01). M-TEER provides a minimally invasive treatment option for mitral regurgitation with favorable early rehabilitation and in-hospital outcomes, particularly in planned hospitalization. However, for unplanned hospitalizations, inpatient outcomes were poor.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"943-951"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preference for advance care planning in patients with pulmonary hypertension.","authors":"Kazuki Tobita, Hayato Sakamoto, Takumi Inami, Daisuke Fujisawa, Kaori Takeuchi, Hanako Kikuchi, Ayumi Goda, Kyoko Soejima, Takashi Kohno","doi":"10.1007/s00380-025-02542-6","DOIUrl":"10.1007/s00380-025-02542-6","url":null,"abstract":"<p><p>Implementing advance care planning (ACP) is recommended in clinical guidelines. However, in pulmonary hypertension, patients' preference toward ACP remains unclear. We aimed to elucidate the preference of patients with pulmonary hypertension for ACP conversations and the association of ACP with important patient factors underlying treatment decision-making. We conducted a cross-sectional questionnaire-based study, assessing patients' preferred and actual participation in ACP conversations, as well as important patient factors underlying their treatment decision-making (including prognosis; patient values; physician recommendation; and symptom, financial, family, and social burdens). Univariate logistic regression analysis was conducted to identify patients with positive attitudes toward ACP conversations. Of 133 patients with pulmonary hypertension (median age, 60 years; mean pulmonary arterial pressure, 23 mmHg; female, 71.4%), 78.2% recognized the importance of ACP conversations. Regarding the patients' perception of appropriate ACP timing, 37.8% chose after repeated hospitalizations for worsening pulmonary hypertension and 22.4% chose during readmission for worsening pulmonary hypertension. Among these, 40.8% engaged in ACP conversations. A positive attitude toward ACP conversations was associated with marital status (married), having children, better oxygenation, and patients' preference toward physician recommendations in pulmonary hypertension treatment decision-making, but not with age, pulmonary hypertension etiology, or other patient preferences in treatment decision-making. Most patients with pulmonary hypertension preferred ACP conversations. A positive attitude toward ACP was associated with patients' preference toward physicians' recommendations in pulmonary hypertension treatment decision-making. Further research is required to establish an appropriate ACP approach that aligns with patient preference and physician recommendations for this patient population.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"925-933"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical importance of heart disease screening in school for detecting atrial septal defects with significant shunt.","authors":"Keitaro Tsuda, Yoshiyuki Kagiyama, Koki Kiyomatsu, Ryuta Takase, Yozo Teramachi, Kenji Suda","doi":"10.1007/s00380-025-02608-5","DOIUrl":"https://doi.org/10.1007/s00380-025-02608-5","url":null,"abstract":"<p><p>In Japan, some first-, seventh-, and tenth-grade students with atrial septal defects (ASDs) are diagnosed through heart disease screening in schools (HDSS) using electrocardiography (ECG). This study evaluated the clinical relevance of HDSS in diagnosing ASD in patients requiring treatment. The study included patients aged 6-40 years who underwent transcatheter ASD closure (TC-ASD) between February 2014 and December 2019. Data on diagnostic opportunities, age at diagnosis, TC-ASD procedure, body size, defect size, physical examination findings, echocardiography, ECG, and cardiac catheterization were collected from medical records. Among 270 patients, 173 met the inclusion criteria. The diagnostic opportunities were HDSS (51%), incidental detection (23%), and infant-toddler health check-ups (19%). In the HDSS group, 83% were referred for secondary screening due to abnormal ECG findings, primarily incomplete right bundle branch block, and 15% had cardiac murmurs. Notably, 17% of the entire cohort was referred solely due to electrocardiographic abnormalities without significant murmurs. These findings underscore the value of HDSS as a school-based screening system for early detection of ASD. Universal ECG screening plays a crucial role in identifying asymptomatic patients with significant defects, and repeated screening across multiple school grades further increases the likelihood of detecting clinically important ASDs that may otherwise be missed at an early stage. This study supports the importance of continued implementation of structured pediatric screening programs in schools.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and predictors of postoperative atrial fibrillation in patients with preoperative sinus rhythm undergoing cardiac or aortic surgery.","authors":"Norimasa Haijima, Mikihiko Kudo, Satoru Murata, Takuya Ono, Hideyuki Shimizu","doi":"10.1007/s00380-025-02610-x","DOIUrl":"https://doi.org/10.1007/s00380-025-02610-x","url":null,"abstract":"<p><p>Postoperative atrial fibrillation (POAF) is frequent after cardiac or aortic surgery and is linked to adverse outcomes. We evaluated the incidence and independent predictors of POAF in patients with preoperative sinus rhythm. We conducted a single-center retrospective cohort study of 78 patients undergoing cardiac or aortic surgery (May 2022-December 2024). POAF during the index hospitalization was modeled using multivariable logistic regression with three prespecified predictors: transmitral early (E) to late (A) diastolic filling velocity ratio (E/A)(per + 1.0), CHADS₂ ≥ 2, and abnormal body mass index (BMI) (< 18.5 or ≥ 25.0 kg/m²). Model performance was summarized by AUC (DeLong 95% CI), Brier score, calibration metrics, and Akaike information criterion (AIC). POAF occurred in 49/78 patients (62.8%). Higher E/A independently predicted POAF (adjusted OR 19.38; 95% CI 3.92-141.87; p = 0.001), as did CHADS₂ ≥ 2 (adjusted OR 4.39; 95% CI 1.31-17.50; p = 0.024) and abnormal BMI (adjusted OR 5.08; 95% CI 1.51-20.44; p = 0.011). The model showed good discrimination (AUC 0.806; 95% CI 0.709-0.904) and acceptable calibration (Brier 0.168; Hosmer-Lemeshow p = 0.530 with g = 10; calibration slope 1.00; intercept 0.00). AIC was 93.50. In patients with preoperative sinus rhythm, higher E/A (continuous), CHADS₂ ≥ 2, and abnormal BMI independently predict POAF, with good model discrimination and calibration. Routine preoperative echocardiography combined with simple clinical indices may aid perioperative risk stratification.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of coronary revascularization on clinical outcomes in vessels with discordant results of fractional flow reserve and resting full-cycle ratio.","authors":"Tatsuro Yamazaki, Yuichi Saito, Shunsuke Nakamura, Yuya Tanabe, Hideki Kitahara, Yoshio Kobayashi","doi":"10.1007/s00380-025-02605-8","DOIUrl":"https://doi.org/10.1007/s00380-025-02605-8","url":null,"abstract":"<p><p>Fractional flow reserve (FFR) is an invasive standard, and resting full-cycle ratio (RFR), a non-hyperemic pressure ratio, is an alternative to FFR for evaluating the functional severity of coronary stenosis. However, the prognostic impact of coronary revascularization in vessels with discordant results of FFR and non-hyperemic pressure ratios remains unclear. This single-center study included 212 vessels in 191 patients with intermediate coronary stenosis and discordant results of FFR and RFR. FFR ≤ 0.80 and RFR ≤ 0.89 were considered physiologically positive. Vessels with discordant results of FFR and RFR were divided into two groups according to the revascularization strategies-the deferral and revascularization groups. The primary endpoint was target vessel failure (TVF), a composite of cardiac death and target vessel myocardial infarction and unplanned revascularization. Of the 212 vessels, 145 (68.4%) and 67 (31.6%) were categorized as the deferral and revascularization groups, respectively. The deferral group was more likely to be older and women than the revascularization group. FFR values were higher, and the rate of positive FFR was lower in the deferral group than in the revascularization group. During the median follow-up of 406 days, 12 of 212 (5.7%) developed TVF. The Kaplan-Meier analysis demonstrated that the TVF rate was significantly lower in the revascularization group than the counterpart (7.6% vs. 1.5% at 3 years, P = 0.046). In conclusion, coronary revascularization in vessels with discordant results of FFR and RFR was associated with lower TVF rates as compared with the deferral strategy.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcomes of nonsteroidal anti-inflammatory drug-related heart failure in real-world Japanese practice: a retrospective cohort study.","authors":"Masakazu Miura, Tomoaki Ienaga, Fumiaki Nakao, Takeshi Ueyama, Yasuhiro Ikeda","doi":"10.1007/s00380-025-02603-w","DOIUrl":"https://doi.org/10.1007/s00380-025-02603-w","url":null,"abstract":"<p><p>Although nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for musculoskeletal pain, their use in patients with heart failure (HF) is discouraged because of risks of fluid retention and worsening disease. Nevertheless, in older patients, NSAIDs are still prescribed by non-cardiologists. We conducted a single-center retrospective cohort study of patients aged ≥ 65 years who were hospitalized for acute decompensated HF at Yamaguchi Prefectural General Medical Center between January 2016 and January 2022. Patients were classified as NSAIDs-related HF if NSAIDs use for ≥ 1 week before admission was identified through pharmacist review. As part of comprehensive cardiac rehabilitation, all patients received self-management guidance on medications, including NSAIDs avoidance. Multivariate Cox proportional hazards models were applied to assess associations with clinical outcomes. Among 801 patients, 64 (8.0%) were classified as NSAIDs-related HF and 737 (92.0%) as NSAIDs-unrelated HF. NSAIDs-related HF cases more frequently represented first-time HF hospitalizations. For the primary endpoint of all-cause mortality or HF readmission, the NSAIDs-related group showed a trend toward improved outcomes, although the difference did not reach statistical significance (hazard ratio [HR] 0.569, 95% confidence interval [CI] 0.289-1.118; p = 0.102). In contrast, the incidence of the secondary endpoint, major adverse cardiac and cerebrovascular events (MACCE), was significantly lower in the NSAIDs-related group (HR 0.404, CI 0.178-0.917; p = 0.030). NSAIDs-related HF accounted for a modest proportion of new HF hospitalizations in older patients. After standard management and NSAIDs discontinuation, outcomes were comparable to those of other HF patients, with a trend toward fewer adverse events. These findings likely reflect differences in patient background and comprehensive rehabilitation rather than a direct protective effect of discontinuation.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of preoperative weight loss on recovery after cardiac surgery.","authors":"Shuri Nakao, Masato Ogawa, Sho Fukuhara, Shinya Sato, Kei Imaoka, Ikumi Kurosaki, Norimasa Egusa, Junya Tanabe, Kazuhiro Yamazaki, Sokichi Maniwa","doi":"10.1007/s00380-025-02602-x","DOIUrl":"https://doi.org/10.1007/s00380-025-02602-x","url":null,"abstract":"<p><p>To examine the impact of preoperative weight fluctuations on postoperative outcomes in patients underwent elective cardiovascular surgery. This retrospective study included 157 consecutive patients who underwent elective cardiovascular surgery between April 2018 and March 2023. We assessed weight changes during a median surgical waiting period of 42 days. The primary outcome was the postoperative length of hospital stay. Patients were stratified into two groups-weight loss and weight maintenance-based on a 1-standard deviation (SD) reduction in weight variability. Multiple regression analysis was performed with adjustments for confounding factors. The mean weight change was + 1.9%, and the threshold for definition of the 'weight loss' and 'weight maintenance' groups was set at 1 SD (- 1.5%). The weight loss group (n = 22, 14%), with a weight loss that exceeded 1.5%, had significantly length of hospital stay been prolonged by a median of 5.0 days compared to the weight maintenance group (n = 135, 86%) (21.0 [17.0, 28.0] vs 26.0 [19.3, 42]; p = 0.03). In a multivariate analysis, weight change of - 1.5% (p < 0.01), eGFR (p = 0.04), and intubation days (p < 0.01) were significantly associated. Unintentional preoperative weight loss exceeding 1.5% was associated with a longer hospital stay. The identification of unintentional preoperative weight loss could aid clinicians in preoperative guidance and risk stratification.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antipsychotic use and dysphagia risk in acute heart failure: a prospective cohort study.","authors":"Haruyo Matsuo, Yoshihiro Yoshimura, Yuichi Maeno, Sayoko Tanaka","doi":"10.1007/s00380-025-02606-7","DOIUrl":"https://doi.org/10.1007/s00380-025-02606-7","url":null,"abstract":"<p><p>While antipsychotic drugs are known to induce dysphagia, their impact on patients with acute heart failure (AHF) remains largely unexplored. This study investigates the critical association between antipsychotic use and both swallowing and physical function in AHF patients. A prospective cohort study was conducted on hospitalized patients with AHF. We rigorously examined the relationship between antipsychotic drug use during hospitalization and outcomes at discharge. Antipsychotic drug use was defined as the regular administration of oral medication. The primary outcome was dysphagia, evaluated using the Food Intake Level Scale (FILS), with secondary outcomes including physical function (Barthel Index) and dysphagia incidence. We employed sophisticated statistical analyses, including multiple regression, logistic regression, and Cox proportional hazards models, adjusting for an extensive range of potential confounders to ensure robust results. Among 325 eligible patients (mean age 81.5 years, 53.2% female), our findings reveal a striking association between antipsychotic use and impaired swallowing function; with 34 patients (10.5%) in the antipsychotic drug use group. Antipsychotic users (34/325, 10.5% of cohort) showed significantly higher odds of dysphagia at discharge (OR = 7.724; 95% CI, 2.585-23.081, p < 0.001) and increased dysphagia incidence during hospitalization (HR = 1.635, 95% CI, 1.002-2.669, p  = 0.049). Notably, antipsychotic use was not associated with Barthel Index at discharge (β = 0.015; p = 0.658), suggesting a specific effect on swallowing function. This study provides compelling evidence that antipsychotic use in AHF patients is associated with a markedly increased risk of dysphagia.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic value of the syncope-to-ILR interval on syncope etiology.","authors":"Kosuke Katano, Yoshitaka Asano, Kimihiro Osada, Akira Miyabe, Shakya Sandeep, Ryuma Ishihara, Atsushi Tosaka, Yoko Ito, Yuriko Sato, Masako Maeda, Taisuke Mizumura, Toshitake Tamamura, Yoichi Sugimura","doi":"10.1007/s00380-025-02607-6","DOIUrl":"https://doi.org/10.1007/s00380-025-02607-6","url":null,"abstract":"<p><strong>Objective: </strong>Implantable loop recorders (ILRs) are useful in determining syncope etiology. We observed a higher diagnostic rate in patients receiving early implantation. We hypothesized that shorter implantation times were associated with higher diagnostic rates and investigated how the syncope-to-ILR interval affected diagnosis.</p><p><strong>Methods: </strong>Medical data of patients at our hospital with syncope of unknown etiology who received ILRs between January 2017 and July 2023 were analyzed in relation to the date of syncope, first visit, and ILR use. Patients were classified into event and non-event groups according to whether ILRs revealed the syncope etiology.</p><p><strong>Results: </strong>We examined the medical records of 113 patients (median age, 72.6 ± 13.1 years). Syncope etiologies were identified in 34 (30%) patients. We identified 37 (16-58) syncope-to-ILR days. The event group had significantly shorter syncope-to-ILR days (event group, 28 days; non-event group, 44 days, p = 0.001) and syncope-to-first visit days (1.5 vs. 13 days, respectively; p = 0.00). To improve diagnostic rates, a receiver operating characteristic curve indicated cut-off values for syncope-to-ILR days and syncope-to-first visit days of 17 and 12 days (area under the curve, 0.69 and 0.74), respectively. Patients accompanied by family or friends underwent ILR placement significantly earlier than unaccompanied patients.</p><p><strong>Conclusion: </strong>The number of syncope-to-ILR days significantly affected syncope diagnosis, indicating that early hospital attendance following syncope is critical. Public awareness campaigns and the presence of family or friends may be useful.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of same-day discharge after transcatheter aortic valve replacement: the North Shore Day Stay pathway.","authors":"Karan Rao, Princess Neila Litkouhi, Alexandra Baer, Peter Hansen, Ravinay Bhindi","doi":"10.1007/s00380-025-02598-4","DOIUrl":"https://doi.org/10.1007/s00380-025-02598-4","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) is an established treatment for patients with severe symptomatic aortic stenosis but expanding indications have increased strain on hospital resources. Several studies assessed same-day discharge (SDD) after TAVR during the COVID-19 pandemic and showed it to be safe in well-selected, low-risk patients. However, more studies are warranted, with no studies in an Australian population and minimal data on self-expanding valves. Patients undergoing consecutive, transfemoral TAVR procedures at two large-volume centres in Sydney, Australia between 2021 and 2023 were prospectively recruited to the CONDUCT-TAVI study cohort. A locally derived clinical pathway ('The North Shore Pathway') was retrospectively applied to identify which patients would have been suitable for SDD. In-hospital and 30-day outcomes were compared between SDD patients and the remaining, ineligible patients (standard discharge cohort). Of 182 patients, 20 (11.0%) met SDD criteria. The total cohort received both self-expanding (67.3%) and balloon-expandable valves (32.7%). The SDD cohort had a higher proportion of females (55.0% vs. 21.5%, p = 0.04) but was otherwise comparable in baseline and procedural characteristics. No significant differences were found in hospital or 30-day outcomes. One SDD patient was readmitted with complete heart block requiring pacemaker implantation (day 20), and two patients had non-cardiovascular readmissions. No other adverse outcomes occurred in the SDD cohort. The present study suggests SDD after TAVR is feasible in both balloon-expandable and self-expanding cohorts. The study also supports prospective validation of the North Shore Day Stay pathway as a tool to safely identify low-risk patients that are suitable for SDD after TAVR.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}