547 Same Day Discharge Following Percutaneous Closure of Structural Heart Conditions: A Novel and Safe Approach for Patient Management

Abstract

Percutaneous closure of patent foramen ovale (PFO) and atrial septal defects (ASD) has become more commonly performed due to recent changes in international guidelines supporting its use. The safety and effectiveness of same day discharge (SDD) home for outpatients who present electively for such procedures has not been examined. We sought to retrospectively investigate the rates of SDD at our institution and review its safety by examining clinical outcomes following elective percutaneous PFO or ASD closure. We also performed an economic analysis evaluating our hospital’s cost data for SDD following these procedures. Patients undergoing elective percutaneous PFO, ASD or PDA closure at St George Hospital, Australia, from January 2011 to January 2020 were evaluated. Primary outcomes included 7-day major adverse cardiovascular endpoints (MACE) and readmission to hospital within 30 days. 24 patients were included in the primary analysis. 10 (41.7%) patients underwent elective ASD closure while 14 (58.3%) underwent PFO closure. Among 24 patients who underwent elective percutaneous closure of structural heart disease, 23 patients (95.8%) were managed with SDD. There were no MACE outcomes at 30 days. No patients were re-admitted to hospital at 30 days following these procedures. When compared to overnight admission to hospital post elective percutaneous structural heart condition closure, SDD yielded a cost saving of $4,817 per case. SDD following elective percutaneous structural heart condition closure was demonstrated to be a safe and effective strategy for managing patients that was also associated with significant cost savings to hospitals.