Discharge After Transcatheter Aortic Valve Implantation: Observational Study of Self-Reported Experiences and Health Status in the Very Early Recovery Period.

BACKGROUND

Early discharge home is the standard of care after transcatheter aortic valve implantation (TAVI). Transition home can be challenging for this population. We lack evidence of patients' experiences during their immediate recovery to develop targeted and effective interventions. We aimed to describe patients' self-reported readiness; supports for early discharge; and very early experience of physical health status, activities of daily living, and procedure-related events after TAVI.

METHODS

We conducted a prospective observational study at five Canadian hospitals; registered nurses and nurse practitioners conducted telephone assessments three and 10 days after TAVI to document patients' self-reports.

RESULTS

We recruited 188 patients (81.6 years, SD ​= ​7.0, 41.5% female) treated with local anesthesia or conscious sedation (n ​= ​171, 91.0%) and balloon-expandable device (77.7%). All patients reported feeling "totally ready" (88.1%) or "somewhat ready" (11.9%) for discharge, and 95.5% returned home with social support. On day 3, most participants completed all activities of daily living (n ​= ​165, 93.2%) and at least six instrumental activities of daily living (n ​= ​105, 59.3%). Their self-reported level of energy was moderate (n ​= ​89, 51.7%), high, or very high (n ​= ​34, 19.8%) and increased by 88.4% by day 10 (n ​= ​49). On day 3, most patients (n ​= ​139, 80.3%) restricted their mobilization to their home, with a 77% increase in daily walking by day 10.

CONCLUSIONS

Most patients report high level of self-efficacy, self-care behavior, and improved physical status in the first week after TAVI. Research is needed to identify, monitor, and intervene in patients who do not follow this trajectory.