Feasibility and Safety of Same-Day Discharge Following Elective Mitral Transcatheter Edge-to-Edge Repair

BACKGROUND: Data on the feasibility and safety of same-day discharge (SDD) following mitral transcatheter edge-to-edge repair (M-TEER) remain limited. OBJECTIVES: The objective of the study was to evaluate the contemporary trends and outcomes of SDD following M-TEER. METHODS: We reviewed the Nationwide Readmissions Database (2016-2022) to compare SDD following elective M-TEER with next-day discharge (NDD). The primary outcome was unplanned all-cause readmissions within 90 days. Secondary outcomes included 90-day heart failure (HF) readmissions and index hospitalization costs. Readmissions were compared using a Cox proportional hazards regression model. RESULTS: A total of 39, 804 weighted hospitalizations for M-TEER were included, of which 1. 2% involved SDD, 69. 0% NDD, and 29. 8% second- or third-day discharge (ScD/TDD). From 2016 to 2022, the proportion of SDD and NDD increased from 0. 4% to 2. 4% and 47. 9% to 76. 7%, respectively, whereas ScD/TDD decreased from 51. 7% to 20. 9% (all ptrend<0. 001). SDD was associated with a similar risk of 90-day all-cause readmission (14. 8% vs 12. 5%; adjusted HR: 1. 25; 95% CI: 0. 90-1. 74) and HF readmission (4. 4% vs 3. 7%; adjusted HR: 1. 22; 95% CI: 0. 67-2. 22) and significantly lower index hospitalization costs (38, 029 vs 43, 319; P = 0. 03) compared to NDD. ScD/TDD was associated with a higher risk of 90-day HF readmission-but not all-cause readmission-and higher index hospitalization costs (49, 648 vs 43, 319; P < 0. 001) compared to NDD. CONCLUSIONS: SDD following M-TEER is uncommon but associated with a similar risk of 90-day readmission and lower index hospitalization costs compared to NDD. Further research is warranted to identify optimal patient selection criteria for SDD after M-TEER.