TY - JOUR
T1 - Update on Minimalist TAVR Care Pathways
T2 - Approaches to Care in 2022
AU - Sawan, Mariem A.
AU - Calhoun, Avery E.
AU - Grubb, Kendra J.
AU - Devireddy, Chandan M.
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/9
Y1 - 2022/9
N2 - Purpose of Review: This review summarizes current data supporting a minimalist TAVR approach and identifies the need for additional study to optimize TAVR care. The authors discuss future directions of the TAVR landscape and how this necessitates evolution of minimalist care pathways. Recent Findings: Transcatheter aortic valve replacement (TAVR) has become a mainstay in the treatment of aortic stenosis since the initial procedure in 2002. Recently, attention has shifted to TAVR optimization and the minimalist approach with a focus on minimizing procedural sedation, protocolization of perioperative management, and prioritization on early discharge. This approach has been shown to be safe and reduce procedure time, length of stay, and overall cost for hospital systems. Summary: The minimalist care pathway avoids general anesthesia, shortens procedure time and length of stay, and reduces cost without changing mortality or readmission rates at 30 days. A variety of protocols have been proposed without a clear consensus on specific components or patient eligibility. There is a continued need for data regarding patient risk stratification, valve selection, and discharge strategy as TAVR becomes increasingly common.
AB - Purpose of Review: This review summarizes current data supporting a minimalist TAVR approach and identifies the need for additional study to optimize TAVR care. The authors discuss future directions of the TAVR landscape and how this necessitates evolution of minimalist care pathways. Recent Findings: Transcatheter aortic valve replacement (TAVR) has become a mainstay in the treatment of aortic stenosis since the initial procedure in 2002. Recently, attention has shifted to TAVR optimization and the minimalist approach with a focus on minimizing procedural sedation, protocolization of perioperative management, and prioritization on early discharge. This approach has been shown to be safe and reduce procedure time, length of stay, and overall cost for hospital systems. Summary: The minimalist care pathway avoids general anesthesia, shortens procedure time and length of stay, and reduces cost without changing mortality or readmission rates at 30 days. A variety of protocols have been proposed without a clear consensus on specific components or patient eligibility. There is a continued need for data regarding patient risk stratification, valve selection, and discharge strategy as TAVR becomes increasingly common.
KW - Minimalist TAVR
KW - Minimalist care pathway
KW - Next-day discharge
KW - Same-day discharge
KW - Transcatheter aortic valve replacement (TAVR)
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U2 - 10.1007/s11886-022-01737-x
DO - 10.1007/s11886-022-01737-x
M3 - Review article
C2 - 35767177
AN - SCOPUS:85133205478
SN - 1523-3782
VL - 24
SP - 1179
EP - 1187
JO - Current Cardiology Reports
JF - Current Cardiology Reports
IS - 9
ER -