Exploring patient perspectives of day-case transcatheter aortic valve implantation: a qualitative study

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Background: Day-case programmes for patients undergoing elective transcatheter aortic valve implantation are emerging as the next step in streamlining patient pathways, with potential benefits for healthcare resource use, cost reduction and patient experience. While safety and feasibility have been demonstrated, there is limited evidence regarding patient perspectives of this approach. Methods: The most recent 30 patients who underwent elective transfemoral transcatheter aortic valve implantation with same-day admission and discharge at a single UK centre were retrospectively identified. All patients were invited to participate in a semi-structured interview with open-ended questions exploring preparedness, education, emotional responses, social and practical arrangements, as well as follow-up support. Interviews were analysed thematically. Results: 24 of the 30 patients agreed to participate (response rate 80%). Most participants ( n =20, 83%) recalled advance discussion of same-day discharge at pre-assessment, though only 58% recalled this being reiterated on admission. Overall, 92% felt very well prepared for discharge, and all reported receiving adequate information. Nearly all participants (95%) felt that their individual circumstances were considered, with around half making practical arrangements, such as transport or overnight support. Emotional responses were largely positive, with patients feeling reassured and happy to return home, as well as low pre- and post-procedure anxiety scores supporting these experiences. Post-discharge follow-up via next-day telephone call was valued by 92% of participants, providing reassurance and an additional layer of clinical safety. Satisfaction with the pathway was high, and all participants reported that they would recommend same-day discharge to others, provided patients felt clinically well. Conclusions: Patients perceive same-day discharge following transcatheter aortic valve implantation as safe, acceptable, and often preferable when supported by clear communication, careful consideration of social context, and structured post-discharge follow-up. These findings highlight the importance of patient-centred education and support for the successful implementation of day-case transcatheter aortic valve implantation pathways.

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