An ultra-rapid outpatient pathway for selected acute valve syndrome patients undergoing TAVI can successfully reduce total length of hospital stay without a significant increase in death or acute decompensation prior to TAVI.
Outpatient TAVI pathway significantly reduced total length of hospital stay compared to inpatient management.
Approximately half of AVS patients evaluated for the outpatient pathway met criteria for outpatient treatment.
There was no significant difference in time from referral to TAVI between outpatient and inpatient pathways.
The outpatient pathway did not result in a significant increase in death or acute decompensation prior to TAVI.
Up to 30% of patients undergoing TAVI present with acute decompensation of aortic stenosis (acute valve syndrome), and conventional inpatient management is associated with prolonged stays and deconditioning.
This research suggests that some patients who are hospitalised with a dangerous worsening of severe aortic stenosis (a heart valve problem called 'acute valve syndrome') can be safely sent home sooner and return as outpatients for their valve replacement procedure (called TAVI), rather than staying in hospital throughout their entire treatment. In this single-centre study, about half of eligible patients (55%) met criteria to be discharged home and complete their pre-procedure tests as outpatients, with TAVI performed within two weeks. These outpatients spent a median of 12 days total in hospital, compared to 20 days for those managed the traditional inpatient way — saving an estimated 210 hospital bed-days overall. Importantly, the faster discharge did not appear to make patients less safe. The rate of serious events (death or emergency re-admission before the valve procedure) was similarly low in both groups — around 6–7% — and was unchanged compared to the period before the new pathway was introduced. The time from referral to actually receiving the valve procedure was also similar between groups, meaning outpatients did not wait any longer for treatment. This research suggests that for carefully selected and stabilised patients with acute valve syndrome, an ultra-rapid outpatient TAVI pathway is both feasible and appears safe, while meaningfully reducing the time patients spend in hospital. Shorter hospital stays can help patients avoid the physical decline that comes from prolonged bed rest, and can free up hospital resources. The authors note that further research with larger patient numbers is needed to fully validate this approach.
Vibhishanan J, Winn K, Ferreira-Martins J, Sharma H, Hosin A, Konstanciak K, et al.. (2026). Ultra-rapid outpatient treatment of patients with severe aortic stenosis presenting with acute valve syndrome: evaluation of a novel pathway for urgent TAVI.. Open heart. https://doi.org/10.1136/openhrt-2026-004222