Safety of Next-Day Discharge After Transfemoral Transcatheter Aortic Valve Replacement With a Self-Expandable Versus Balloon-Expandable Valve Prosthesis.

Background The safety of next-day discharge (NDD) after transcatheter aortic valve replacement (TAVR) with a self-expandable valve is unknown. We investigated the safety of NDD after TAVR in patients who received a self-expandable valve or balloon-expandable valve. Methods and Results We retrospectively evaluated consecutive patients who underwent elective minimalist TAVR between January 2017 and July 2018. We investigated the success rates and predictors of NDD after TAVR. Ninety-day and 1-year outcomes in patients managed with NDD after self-expandable ACURATE neo or balloon-expandable SAPIEN 3 replacement were compared. In 315 TAVRs, 249 patients received an ACURATE neo (n=146) or SAPIEN 3 (n=103) valve. There were no differences in baseline characteristics. In the ACURATE neo and SAPIEN 3 groups, NDD was achieved in 60% (n=87) and 55% (n=57) of patients, respectively ( P>0.50). Predictors of NDD included chronic obstructive pulmonary disease (odds ratio, 0.49; 95% CI, 0.25-0.94) and low pre-TAVR hemoglobin (odds ratio, 0.98; 95% CI, 0.96-0.99) but not type of valve (odds ratio, 1.20; 95% CI, 0.71-1.98 for ACURATE neo). After excluding non-NDD cases, there were no significant differences in 90-day mortality (0% versus 0%; P>0.90) or new pacemaker implantation (1% versus 0%; P>0.40) between ACURATE neo and SAPIEN3, respectively. No significant difference in 1-year mortality between ACURATE neo and SAPIEN 3 groups after NDD (8% versus 10%; log-rank, P>0.80) was observed. Conclusions The safety of NDD using ACURATE neo was similar that using SAPIEN 3, with comparable 90-day and 1-year outcomes.