# Ultrarapid outpatient pad verkort verblijfsduur voor urgente TAVI bij acute aortastenose

*geplaatst 2026-09-21 · Algemeen · Open Heart · doi info:doi/10.1136/openhrt-2026-004222 · https://hartvaat.nl/2026/09/12/ultrarapid-outpatient-pad-verkort-verblijfsduur-voor-urgente-tavi-bij-acute-aort/*

Een eencentrische cohortstudie toont aan dat een ultrarapid outpatient pathway voor geselecteerde patiënten met ernstige aortastenose en acute valve syndroom de totale verblijfsduur voor TAVI aanzienlijk verkort zonder extra veiligheidsrisico's. Patiënten die volgens het nieuwe pad naar huis werden gestuurd voor nabewerking hadden een mediane verblijfsduur van 12 dagen versus 20 dagen bij conventieve opname (p<0,0001), met een vergelijkbare incidentie van overlijden of acute decompensatie voorafgaand aan de ingreep. Deze aanpak kan ziekenhuisbedden ontlasten en herstel versnellen, maar vereist validatie in grotere studies voordat het routinematig wordt toegepast.

## English: Ultra-rapid outpatient treatment of patients with severe aortic stenosis presenting with acute valve syndrome: evaluation of a novel pathway for urgent TAVI

A single-centre cohort study demonstrates that an ultra-rapid outpatient pathway for selected patients with severe aortic stenosis and acute valve syndrome significantly reduces total hospital stay for TAVI without increasing safety risks. Patients managed as outpatients had a median length of stay of 12 days compared to 20 days for inpatients (p<0.0001), with no significant difference in pre-TAVI mortality or acute decompensation. This workflow optimization can free up hospital beds and accelerate recovery, though multicentre validation is needed before widespread adoption.

## Abstract (original, from the publication)

<sec><st>Background</st>
<p>Up to 30% of patients undergoing transcatheter aortic valve implantation (TAVI) have presented to hospital with acute decompensation of aortic stenosis (acute valve syndrome, (AVS)). Such patients conventionally undergo inpatient work-up and treatment by TAVI, associated with prolonged hospital stays, deconditioning and delayed recovery. This study aimed to evaluate the impact and feasibility of an ultra-rapid outpatient pathway for selected, stabilised AVS patients undergoing treatment by TAVI.</p>
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<sec><st>Methods</st>
<p>This single-centre cohort study with preimplementation and postimplementation comparison included consecutive AVS patients referred for TAVI over 6 months pre-pathway implementation and 12 months post-pathway implementation. Those meeting prespecified criteria were discharged home for completion of work-up and treatment by TAVI within 2 weeks. The primary efficacy endpoint was length of hospital stay. The primary safety endpoint was death or acute decompensation prior to TAVI.</p>
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<sec><st>Results</st>
<p>183 patients were included, of which 105 were evaluated for outpatient treatment after ultra-rapid pathway introduction. 58/105 (55.2%) met criteria for outpatient treatment, the remaining 47/105 (44.8%) were managed as inpatients. There was no significant difference in demographic or echocardiographic characteristics between management pathways. Patients treated as an outpatient had a shorter median total length of hospital stay (outpatient 12 days (IQR 7&ndash;17) vs inpatient 20 days (IQR 15&ndash;32), p&lt;0.0001), saving an estimated 210 hospital bed-days. There was no significant difference in median time from referral to TAVI (outpatient 15 days (IQR 13&ndash;20) vs inpatient 14 days (IQR 10&ndash;18), p=0.22), nor in the incidence of the safety endpoint prior to TAVI between pathways (outpatient 6.9% vs inpatient 6.4%, HR 0.97, 95% CI 0.22 to 4.34, p=0.97), or after new pathway implementation (pre-pathway 6.7%, post-pathway 6.7%, HR 0.70, 95% CI 0.17 to 2.80, p=0.61).</p>
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<sec><st>Conclusions</st>
<p>An ultra-rapid outpatient pathway for selected AVS patients undergoing treatment by TAVI can successfully reduce total length of hospital stay. Further work is required to validate this approach.</p>
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Auteurs: Vibhishanan, J., Winn, K., Ferreira-Martins, J., Sharma, H., Hosin, A., Konstanciak, K., Matos Dias, J., Gurreiro De Almeida, J., Hundertmark, C., Bulman, S., Fullerton, J. N., Dawkins, S., Franks, R., Kharbanda, R. K., Newton, J. D., Banning, A. P., Cahill, T. J.

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Bron: Open Heart, https://doi.org/info:doi/10.1136/openhrt-2026-004222. Bijgewerkt 2026-09-14T01:25:25Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.