Post-TAVR Care Guidelines

Immediate Post-Procedure Monitoring

The American College of Cardiology recommends continuous telemetry monitoring to detect conduction abnormalities and arrhythmias in patients after TAVR, with a focus on the first 24-72 hours 1, 2, 3, 4
Monitoring of vital signs, including blood pressure and heart rate, is crucial in the post-TAVR period, according to the American College of Cardiology 1, 2
Assessing volume status meticulously through intake/output monitoring is essential to prevent hypovolemia and fluid overload, as recommended by the American College of Cardiology 1, 2, 5
Vigilant monitoring of the access site is necessary to detect bleeding, hematoma formation, or pseudoaneurysm development early, with consideration of ultrasound if concerns arise, as suggested by the American College of Cardiology 1, 2

The American College of Cardiology suggests mobilizing patients as soon as the access site allows, emphasizing the importance of early mobilization in elderly patients with high comorbidity burden 1, 2
Initiating physical and occupational therapy assessment is recommended to determine appropriate post-hospitalization disposition, according to the American College of Cardiology 1, 2

Providing appropriate pain management tailored to elderly patients is recommended by the American College of Cardiology 1, 2
Reviewing and restarting preoperative medications promptly is essential, ensuring all appropriate medications are resumed, as suggested by the American College of Cardiology 1, 2, 5

Obtaining a predischarge echocardiogram is recommended to establish baseline valve function, including transvalvular velocity, mean gradient, valve area, and assessment of paravalvular regurgitation, according to the American College of Cardiology 1, 7
Starting aspirin 75-100 mg daily lifelong is recommended, with the addition of clopidogrel 75 mg daily for 3-6 months in patients without an indication for anticoagulation, as suggested by the American College of Cardiology 1, 3, 7

The American College of Cardiology advises against delaying discharge unnecessarily, as early discharge within 72 hours does not increase 30-day mortality, bleeding, pacemaker implantation, or rehospitalization rates in selected transfemoral TAVR patients 2, 3
Ongoing surveillance for conduction abnormalities is necessary, as pacemaker needs can emerge beyond the initial 30-day period, according to the American College of Cardiology 7
The American College of Cardiology recommends against underestimating readmission risk, as over 40% of patients are readmitted within the first year, with 60% of readmissions due to non-cardiac causes 2, 3, 4
Neglecting comorbidity management is discouraged, as outcomes depend strongly on overall patient health and management of conditions beyond the aortic valve disease, according to the American College of Cardiology 2, 6