Discharge after TAVI: it can be fast

Transcatheter aortic valve implantation (TAVI) can now be considered for any patient with symptomatic severe aortic stenosis (AS) who is set to receive an aortic valve replacement with a bioprosthesis1-4. In particular, the recent low-risk trials may dramatically increase the pool of eligible TAVI candidates, with estimates as high as 270,000 patients in Europe and North America5 . The healthcare challenges for heart valve centres are significant. Different levels within a given TAVI programme require restructuring to cope with this changing supply/demand reality at reasonable cost and without concessions in quality. This includes: 1) stronger ties with referral hospitals to relocate preprocedural TAVI work-up outside of the implanting heart valve centres; 2) implementation of local anaesthesia/mild sedation protocols to minimise catheterisation laboratory occupation time; 3) avoidance of unnecessary time spent in intensive care units and general cardiology/cardiac surgery wards, and 4) harmonising institutional logistics

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