Intraprocedural versus next day transthoracic echocardiography following minimalist transfemoral TAVI

Panagiotis Savvoulidis; M. Adnan Nadir; William E. Moody; Richard Steeds; Peter F. Ludman; Joseph R. Bradley; Aldrin Singh; Ewa Lawton; Sagar N. Doshi

doi:10.1186/s44156-023-00025-w

Intraprocedural versus next day transthoracic echocardiography following minimalist transfemoral TAVI

Panagiotis Savvoulidis, M. Adnan Nadir, William E. Moody, Richard Steeds, Peter F. Ludman, Joseph R. Bradley, Aldrin Singh, Ewa Lawton, Sagar N. Doshi^*

^*Corresponding author for this work

Cardiovascular Sciences

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Abstract

Background: Routine pre-discharge echocardiography (ECHO) is recommended post transcatheter aortic valve implantation (TAVI) as a baseline for future comparison. However, there is no clear guidance on the optimal timing of this study. Aim: The purpose of this retrospective study was to investigate the safety and work-force efficiency of intraprocedural same-day ECHO versus next-day ECHO, following transfemoral TAVI.

Methods and results: In this retrospective study 100 consecutive patients who underwent intraprocedural ECHO only were compared with 100 consecutive patients undergoing both intraprocedural and routine next-day ECHO following elective transfemoral TAVI. All patients received the Sapien 3/Ultra transcatheter heart valve and were treated with a minimalist procedure with conscious sedation. The composite of in-hospital mortality, urgent ECHO and new tamponade after leaving the cath lab and before discharge was not different between the two groups (4 vs. 4%, P = 1). There was no paravalvular leak more than mild in any of the cases. Length of stay was similar (1 day).

Conclusions: Intraprocedural post-TAVI ECHO appears as safe as next day pre-discharge ECHO and obviates the need for a routine next day study, thereby reducing burden on echocardiography services and allows better utilisation of resources.

Original language	English
Article number	14
Number of pages	7
Journal	Echo Research and Practice
Volume	10
Issue number	1
DOIs	https://doi.org/10.1186/s44156-023-00025-w
Publication status	Published - 7 Sept 2023

Keywords

Complications
Next day ECHO
Same day ECHO
Echocardiography guidance
Transcatheter aortic valve implantation

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title = "Intraprocedural versus next day transthoracic echocardiography following minimalist transfemoral TAVI",

abstract = "Background: Routine pre-discharge echocardiography (ECHO) is recommended post transcatheter aortic valve implantation (TAVI) as a baseline for future comparison. However, there is no clear guidance on the optimal timing of this study. Aim: The purpose of this retrospective study was to investigate the safety and work-force efficiency of intraprocedural same-day ECHO versus next-day ECHO, following transfemoral TAVI. Methods and results: In this retrospective study 100 consecutive patients who underwent intraprocedural ECHO only were compared with 100 consecutive patients undergoing both intraprocedural and routine next-day ECHO following elective transfemoral TAVI. All patients received the Sapien 3/Ultra transcatheter heart valve and were treated with a minimalist procedure with conscious sedation. The composite of in-hospital mortality, urgent ECHO and new tamponade after leaving the cath lab and before discharge was not different between the two groups (4 vs. 4%, P = 1). There was no paravalvular leak more than mild in any of the cases. Length of stay was similar (1 day). Conclusions: Intraprocedural post-TAVI ECHO appears as safe as next day pre-discharge ECHO and obviates the need for a routine next day study, thereby reducing burden on echocardiography services and allows better utilisation of resources.",

keywords = "Complications, Next day ECHO, Same day ECHO, Echocardiography guidance, Transcatheter aortic valve implantation",

author = "Panagiotis Savvoulidis and Nadir, {M. Adnan} and Moody, {William E.} and Richard Steeds and Ludman, {Peter F.} and Bradley, {Joseph R.} and Aldrin Singh and Ewa Lawton and Doshi, {Sagar N.}",

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AU - Savvoulidis, Panagiotis

AU - Nadir, M. Adnan

AU - Moody, William E.

AU - Steeds, Richard

AU - Ludman, Peter F.

AU - Bradley, Joseph R.

AU - Singh, Aldrin

AU - Lawton, Ewa

AU - Doshi, Sagar N.

PY - 2023/9/7

Y1 - 2023/9/7

N2 - Background: Routine pre-discharge echocardiography (ECHO) is recommended post transcatheter aortic valve implantation (TAVI) as a baseline for future comparison. However, there is no clear guidance on the optimal timing of this study. Aim: The purpose of this retrospective study was to investigate the safety and work-force efficiency of intraprocedural same-day ECHO versus next-day ECHO, following transfemoral TAVI. Methods and results: In this retrospective study 100 consecutive patients who underwent intraprocedural ECHO only were compared with 100 consecutive patients undergoing both intraprocedural and routine next-day ECHO following elective transfemoral TAVI. All patients received the Sapien 3/Ultra transcatheter heart valve and were treated with a minimalist procedure with conscious sedation. The composite of in-hospital mortality, urgent ECHO and new tamponade after leaving the cath lab and before discharge was not different between the two groups (4 vs. 4%, P = 1). There was no paravalvular leak more than mild in any of the cases. Length of stay was similar (1 day). Conclusions: Intraprocedural post-TAVI ECHO appears as safe as next day pre-discharge ECHO and obviates the need for a routine next day study, thereby reducing burden on echocardiography services and allows better utilisation of resources.

AB - Background: Routine pre-discharge echocardiography (ECHO) is recommended post transcatheter aortic valve implantation (TAVI) as a baseline for future comparison. However, there is no clear guidance on the optimal timing of this study. Aim: The purpose of this retrospective study was to investigate the safety and work-force efficiency of intraprocedural same-day ECHO versus next-day ECHO, following transfemoral TAVI. Methods and results: In this retrospective study 100 consecutive patients who underwent intraprocedural ECHO only were compared with 100 consecutive patients undergoing both intraprocedural and routine next-day ECHO following elective transfemoral TAVI. All patients received the Sapien 3/Ultra transcatheter heart valve and were treated with a minimalist procedure with conscious sedation. The composite of in-hospital mortality, urgent ECHO and new tamponade after leaving the cath lab and before discharge was not different between the two groups (4 vs. 4%, P = 1). There was no paravalvular leak more than mild in any of the cases. Length of stay was similar (1 day). Conclusions: Intraprocedural post-TAVI ECHO appears as safe as next day pre-discharge ECHO and obviates the need for a routine next day study, thereby reducing burden on echocardiography services and allows better utilisation of resources.

KW - Complications

KW - Next day ECHO

KW - Same day ECHO

KW - Echocardiography guidance

KW - Transcatheter aortic valve implantation

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DO - 10.1186/s44156-023-00025-w

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JO - Echo Research and Practice

JF - Echo Research and Practice

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ER -

Intraprocedural versus next day transthoracic echocardiography following minimalist transfemoral TAVI

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Keywords

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