Same day discharge after structural heart disease interventions in the era of the coronavirus-19 pandemic and beyond

With recent advancements in imaging modalities and techniques and increased recognition of the long-term impact of several structural heart disease interventions,the number of procedures has significantly increased.With the increase in procedures,also comes an increase in cost.In view of this,efficient and cost-effective methods to facilitate and manage structural heart disease interventions are a necessity.Same-day discharge(SDD)after invasive cardiac procedures improves resource utilization and patient satisfaction.SDD in appropriately selected patients has become the standard of care for some invasive cardiac procedures such as percutaneous coronary interventions.This is not the case for the majority of structural heart procedures.With the coronavirus disease 2019 pandemic,safely reducing the duration of time spent within the hospital to prevent unnecessary exposure to pathogens has become a priority.In light of this,it is prudent to assess the feasibility of SDD in several structural heart procedures.In this review we highlight the feasibility of SDD in a carefully selected population,by reviewing and summarizing studies on SDD among patients undergoing left atrial appendage occlusion,patent foramen ovale/atrial septal defect closure,Mitra-clip,and trans-catheter aortic valve replacement procedures.

经导管缘对缘修复技术初步实践:MitraClip治疗二尖瓣反流多中心早期结果

目的探讨MitraClip系统中国上市后在国内患者中的早期临床应用结果。方法回顾性分析2021年1—6月在中国医学科学院阜外医院、阜外医院深圳医院、云南省阜外心血管病医院,应用MitraClip系统完成经导管缘对缘手术的36例患者的临床资料,其中男24例、女12例,中位年龄70(47~86)岁,术前二尖瓣反流程度为3+级患者10例(27.8%),4+级患者26例(72.2%)。结果全组患者手术顺利,术毕即刻二尖瓣反流程度较前至少下降2+级,术后3 d二尖瓣反流程度≤2+级患者占91.7%。术后患者左心室射血分数无明显变化,术后二尖瓣前向流速、峰值压差均较术前增快,术后3 d二尖瓣跨瓣平均压差较术毕即刻有所增加(P<0.001)。术中2例患者出现急性心包积液,穿刺引流后好转。结论MitraClip系统在中国患者中应用效果良好,能明显改善二尖瓣反流,与国外研究具有良好的一致性,早期结果令人满意。