Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR
Garrett A. Welle, Bassim El-Sabawi, Jeremy J. Thaden, Kevin L. Greason, Kyle W. Klarich, Vuyisile T. Nkomo, Mohamad A. Alkhouli, Mayra E. Guerrero, Juan A. Crestanello, Rajiv Gulati, Charanjit S. Rihal, Mackram F. Eleid
Objectives: The aim of this study was to determine the safety of eliminating the pre-discharge transthoracic echocardiogram (TTE) on 30-day outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). Background: TTE is utilized before, during, and after TAVR. Post-procedural, pre-discharge TTE assists in assessment of prosthesis function and detection of clinically significant paravalvular leak (PVL) after TAVR. Methods: Patients who underwent TAVR at Mayo Clinic from July 2018 to July 2019 were included in a prospective institutional registry. Patients undergoing TAVR prior to February 2019 received a pre-discharge TTE, while those undergoing TAVR after February 2019 did not. Both cohorts were evaluated with TTE at 30 days post-TAVR. Results: A total of 330 consecutive patients were included. Of these, 160 patients (age 81.1 ± 7.6) had routine pre-discharge TTE, while 170 patients (age 78.9 ± 7.5) were dismissed without routine pre-discharge TTE. Mortality at 30 days was similar between the two groups (0% and 1.2%, respectively). One episode of PVL requiring intervention (0.6%) occurred in the pre-discharge TTE group and none in the group without pre-discharge TTE at 30-day follow-up. There was a similar incidence of total composite primary and secondary adverse events between the cohort receiving a pre-discharge TTE and those without (28.1% vs. 25.3%, P = 0.56) at 30 days. The most common event was need for permanent pacemaker or ICD implantation in both groups (13.1% vs. 11.8%, P = 0.71). Conclusions: Elimination of the pre-discharge TTE is safe and associated with comparable 30-day outcomes to routine pre-discharge TTE. These findings have implication for TAVR practice cost-efficiency and health care utilization.
TTE/TEE
paravalvular leak
percutaneous valve therapy
transcatheter valve implantation
Dive into the research topics of 'Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR'. Together they form a unique fingerprint.
Transcatheter Aortic Valve Replacement Medicine & Life Sciences 100%
Patient Acceptance of Health Care Medicine & Life Sciences 11%
Prostheses and Implants Medicine & Life Sciences 8%
Registries Medicine & Life Sciences 8%
Costs and Cost Analysis Medicine & Life Sciences 6%
Safety Medicine & Life Sciences 5%
Welle, G. A., El-Sabawi, B., Thaden, J. J., Greason, K. L., Klarich, K. W., Nkomo, V. T., Alkhouli, M. A., Guerrero, M. E., Crestanello, J. A., Gulati, R., Rihal, C. S., & Eleid, M. F. (2022). Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR. Catheterization and Cardiovascular Interventions, 99(3), 861-866. https://doi.org/10.1002/ccd.29929
Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR. / Welle, Garrett A.; El-Sabawi, Bassim; Thaden, Jeremy J. et al.
In: Catheterization and Cardiovascular Interventions, Vol. 99, No. 3, 15.02.2022, p. 861-866.
Welle, GA, El-Sabawi, B, Thaden, JJ, Greason, KL, Klarich, KW, Nkomo, VT, Alkhouli, MA, Guerrero, ME, Crestanello, JA, Gulati, R, Rihal, CS & Eleid, MF 2022, 'Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR', Catheterization and Cardiovascular Interventions, vol. 99, no. 3, pp. 861-866. https://doi.org/10.1002/ccd.29929
Welle GA, El-Sabawi B, Thaden JJ, Greason KL, Klarich KW, Nkomo VT et al. Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR. Catheterization and Cardiovascular Interventions. 2022 Feb 15;99(3):861-866. doi: 10.1002/ccd.29929
Welle, Garrett A. ; El-Sabawi, Bassim ; Thaden, Jeremy J. et al. / Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR. In: Catheterization and Cardiovascular Interventions. 2022 ; Vol. 99, No. 3. pp. 861-866.
@article{44ae6a50363944e49d89a3a1901e0c47,
title = "Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR",
abstract = "Objectives: The aim of this study was to determine the safety of eliminating the pre-discharge transthoracic echocardiogram (TTE) on 30-day outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). Background: TTE is utilized before, during, and after TAVR. Post-procedural, pre-discharge TTE assists in assessment of prosthesis function and detection of clinically significant paravalvular leak (PVL) after TAVR. Methods: Patients who underwent TAVR at Mayo Clinic from July 2018 to July 2019 were included in a prospective institutional registry. Patients undergoing TAVR prior to February 2019 received a pre-discharge TTE, while those undergoing TAVR after February 2019 did not. Both cohorts were evaluated with TTE at 30 days post-TAVR. Results: A total of 330 consecutive patients were included. Of these, 160 patients (age 81.1 ± 7.6) had routine pre-discharge TTE, while 170 patients (age 78.9 ± 7.5) were dismissed without routine pre-discharge TTE. Mortality at 30 days was similar between the two groups (0% and 1.2%, respectively). One episode of PVL requiring intervention (0.6%) occurred in the pre-discharge TTE group and none in the group without pre-discharge TTE at 30-day follow-up. There was a similar incidence of total composite primary and secondary adverse events between the cohort receiving a pre-discharge TTE and those without (28.1% vs. 25.3%, P = 0.56) at 30 days. The most common event was need for permanent pacemaker or ICD implantation in both groups (13.1% vs. 11.8%, P = 0.71). Conclusions: Elimination of the pre-discharge TTE is safe and associated with comparable 30-day outcomes to routine pre-discharge TTE. These findings have implication for TAVR practice cost-efficiency and health care utilization.",
keywords = "TTE/TEE, aortic valve disease, paravalvular leak, percutaneous valve therapy, transcatheter valve implantation",
author = "Welle, {Garrett A.} and Bassim El-Sabawi and Thaden, {Jeremy J.} and Greason, {Kevin L.} and Klarich, {Kyle W.} and Nkomo, {Vuyisile T.} and Alkhouli, {Mohamad A.} and Guerrero, {Mayra E.} and Crestanello, {Juan A.} and Rajiv Gulati and Rihal, {Charanjit S.} and Eleid, {Mackram F.}",
note = "Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC.",
T1 - Effect of eliminating pre-discharge transthoracic echocardiogram on outcomes after TAVR
AU - Welle, Garrett A.
AU - El-Sabawi, Bassim
AU - Thaden, Jeremy J.
AU - Greason, Kevin L.
AU - Klarich, Kyle W.
AU - Nkomo, Vuyisile T.
AU - Alkhouli, Mohamad A.
AU - Guerrero, Mayra E.
AU - Crestanello, Juan A.
AU - Gulati, Rajiv
AU - Rihal, Charanjit S.
AU - Eleid, Mackram F.
N1 - Publisher Copyright: © 2021 Wiley Periodicals LLC.
N2 - Objectives: The aim of this study was to determine the safety of eliminating the pre-discharge transthoracic echocardiogram (TTE) on 30-day outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). Background: TTE is utilized before, during, and after TAVR. Post-procedural, pre-discharge TTE assists in assessment of prosthesis function and detection of clinically significant paravalvular leak (PVL) after TAVR. Methods: Patients who underwent TAVR at Mayo Clinic from July 2018 to July 2019 were included in a prospective institutional registry. Patients undergoing TAVR prior to February 2019 received a pre-discharge TTE, while those undergoing TAVR after February 2019 did not. Both cohorts were evaluated with TTE at 30 days post-TAVR. Results: A total of 330 consecutive patients were included. Of these, 160 patients (age 81.1 ± 7.6) had routine pre-discharge TTE, while 170 patients (age 78.9 ± 7.5) were dismissed without routine pre-discharge TTE. Mortality at 30 days was similar between the two groups (0% and 1.2%, respectively). One episode of PVL requiring intervention (0.6%) occurred in the pre-discharge TTE group and none in the group without pre-discharge TTE at 30-day follow-up. There was a similar incidence of total composite primary and secondary adverse events between the cohort receiving a pre-discharge TTE and those without (28.1% vs. 25.3%, P = 0.56) at 30 days. The most common event was need for permanent pacemaker or ICD implantation in both groups (13.1% vs. 11.8%, P = 0.71). Conclusions: Elimination of the pre-discharge TTE is safe and associated with comparable 30-day outcomes to routine pre-discharge TTE. These findings have implication for TAVR practice cost-efficiency and health care utilization.
AB - Objectives: The aim of this study was to determine the safety of eliminating the pre-discharge transthoracic echocardiogram (TTE) on 30-day outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). Background: TTE is utilized before, during, and after TAVR. Post-procedural, pre-discharge TTE assists in assessment of prosthesis function and detection of clinically significant paravalvular leak (PVL) after TAVR. Methods: Patients who underwent TAVR at Mayo Clinic from July 2018 to July 2019 were included in a prospective institutional registry. Patients undergoing TAVR prior to February 2019 received a pre-discharge TTE, while those undergoing TAVR after February 2019 did not. Both cohorts were evaluated with TTE at 30 days post-TAVR. Results: A total of 330 consecutive patients were included. Of these, 160 patients (age 81.1 ± 7.6) had routine pre-discharge TTE, while 170 patients (age 78.9 ± 7.5) were dismissed without routine pre-discharge TTE. Mortality at 30 days was similar between the two groups (0% and 1.2%, respectively). One episode of PVL requiring intervention (0.6%) occurred in the pre-discharge TTE group and none in the group without pre-discharge TTE at 30-day follow-up. There was a similar incidence of total composite primary and secondary adverse events between the cohort receiving a pre-discharge TTE and those without (28.1% vs. 25.3%, P = 0.56) at 30 days. The most common event was need for permanent pacemaker or ICD implantation in both groups (13.1% vs. 11.8%, P = 0.71). Conclusions: Elimination of the pre-discharge TTE is safe and associated with comparable 30-day outcomes to routine pre-discharge TTE. These findings have implication for TAVR practice cost-efficiency and health care utilization.
KW - TTE/TEE
KW - aortic valve disease
KW - paravalvular leak
KW - percutaneous valve therapy
KW - transcatheter valve implantation