Same day discharge after structural heart disease interventions in the era of the coronavirus-19 pandemic and beyond

Table 1 Proposed pre-requisites for same day discharge in structural cardiac procedures

Pre-procedure

Administrative buy-in

Experienced operator

Same day discharge multi-disciplinary team including social workers and nursing

Elective procedure

Reliable means for follow-up

Patient without significant co-morbidities

Willing to depart on the same day

Adequate social support

During procedure

Intra-Procedural monitoring without significant hemodynamic compromise

Successful vascular access without immediate complications

Successful deployment of device

Right atrial pacing for TAVR without wenkebach

Post-procedure

Hemodynamic monitoring for 4-6 h without instability

Able to mobilize without assistance

Vascular access site integrity

TTE without significant pericardial effusion

No new AV block or inter-ventricular conduction delays

Prescriptions arranged

Evening phone call from provider

Next day in-person follow up for imaging and laboratory investigations

AV: Atrioventricular; TAVR: Transcatheter aortic valve replacement; TTE: Transthoracic echocardiogram.