Chowdhury Medhat, Buttar Rupinder, Rai Devesh, Tahir Muhammad Waqas, Tan Bryan E-Xin, Thakkar Samarthkumar, Ali Hammad, Patel Harsh P, Bhatt Deepak L, Depta Jeremiah P
Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.
Department of Internal Medicine, Detroit Medical Center/Wayne State University, Detroit, MI, USA.
Eur Heart J Case Rep. 2021 Oct 1;5(10):ytab397. doi: 10.1093/ehjcr/ytab397. eCollection 2021 Oct.
Due to the current Coronavirus Disease 2019 (COVID-19) pandemic, there is a realization for innovation in procedures and protocols to minimize hospital stay and at the same time ensure continued evidence-based treatment delivered to the patients. We present a same-day discharge protocol for transcatheter mitral valve repair (TMVR) using MitraClip under general anaesthesia in a six-patient case series. This protocol aims to reduce the length of hospital stay, thereby minimizing potential for nosocomial COVID-19 infections and to promote safe discharge with cautious follow-up.
Six patients with severe symptomatic mitral valve (MV) regurgitation underwent successful transfemoral MV repair using standard procedures. Following repair, patients were monitored on telemetry in the recovery area for 3 h, ambulated to assess vascular access stability and underwent post-procedural transthoracic echocardiogram to assess for any pericardial effusion or post-procedural prosthetic mitral stenosis.
Same-day discharge after TMVR is possible when done cautiously with close follow-up, can minimize hospital stay, improve resource utilization, and reduce risk of nosocomial COVID-19 infection.
由于当前的2019冠状病毒病（COVID-19）大流行，人们意识到需要在程序和方案上进行创新，以尽量缩短住院时间，同时确保继续为患者提供循证治疗。我们在一个六例患者的病例系列中，介绍了在全身麻醉下使用MitraClip进行经导管二尖瓣修复（TMVR）的当日出院方案。该方案旨在缩短住院时间，从而将医院获得性COVID-19感染的可能性降至最低，并通过谨慎的随访促进安全出院。
六例有症状的严重二尖瓣反流患者采用标准程序成功进行了经股动脉二尖瓣修复。修复后，患者在恢复区通过遥测监测3小时，下床活动以评估血管通路的稳定性，并接受术后经胸超声心动图检查，以评估是否有心包积液或术后人工二尖瓣狭窄。
TMVR术后谨慎进行并密切随访时可以实现当日出院，这可以缩短住院时间，提高资源利用率，并降低医院获得性COVID-19感染的风险。
