AN UPDATE IN AORTIC VALVE INTERVENTION AND EARLY DISCHARGE.

Severe aortic stenosis is common and carries significant morbidity and mortality in an ever-growing elderly population.

It is now fifteen years since the advent of Transcatheter Aortic Valve Implantation (TAVI). The first ever case was performed in 2002. Since then data from randomised controlled trials supporting favourable outcomes with TAVI for patients in whom surgical aortic valve replacement is considered high risk have led to its inclusion in the latest International guidelines for management of valvular heart disease.

The TAVI programme at the Royal Victoria Hospital was commenced in 2008. Over 700 cases have been performed to date. All cases are considered at our regional heart team meeting (comprising a minimum of general cardiologist, interventional cardiologist and cardiac surgeons) and implementation of our early discharge pathway in 2013 has already shown locally that in a cohort of carefully selected patients next day and even same day discharge can be safely facilitated. Currently, cases from Belfast are included in ongoing international registry work around the feasibility and safety of early discharge.

The TAVI programme continues to thrive, providing patients evaluated by our heart team with a transcatheter solution with short recovery time, reduced length of stay in hospital and good outcomes.