ST. LOUIS - “I should have had the operation a long time ago.”
At 6 a.m., Dick Bonin, 74, was being prepped for the 90 minute TAVR procedure (transcatheter aortic valve replacement) at Mercy Hospital St. Louis. By 6 p.m., he was home. Bonin was the first TAVR same-day discharge patient in the St. Louis area.
“I was happy to go home that quickly,” Bonin said. “The next day, I stayed in bed and did what I was directed, but I was at home.”
Doctors at Mercy Hospital St. Louis were the first in the area to do the TAVR procedure in 2012 after it was FDA approved. Now, they are the first to offer certain patients the opportunity to have it done and be home the same day.
The average length of a hospital stay following TAVR procedures has dropped significantly in the last eight years, starting with stays as long as 10 days. In recent years, as the procedure opened to patients with fewer risk factors and a minimalist approach, including nurse led anesthesia and intracardiac echo, the typical stay has been shortened to 30 to 34 hours.
In 2020, due to bed capacity issues related to the COVID-19 pandemic, hospitals began to study the outcomes of patients who were sent home on the same day and discovered they did well.
“For patients who fit certain criteria, we have a 20-point checklist. It was determined they could be safely sent home and sleep in their own beds,” said Dr. Anthony Sonn, Mercy Clinic interventional cardiologist and Mercy Hospital St. Louis TAVR program director. “Mr. Bonin was the perfect first candidate in St. Louis. He is a younger patient, lives close to the hospital, has a good support system and no significant additional risk factors.”
For his part, Bonin said he didn’t realize how badly he needed the procedure until he had it done. “I love the outdoors, splitting wood and building decks,” Bonin said. “I was having to rest every 10 to 15 minutes before, which was not normal.”
He went to the doctor because his blood pressure was going up and down. From there, he was scheduled for an echocardiogram and a stress test.
“My echo showed such reduced blood flow, I didn’t do the stress test,” Bonin recalled. “I was told they would have likely had to call the ER if I did the stress test.”
Dr. Sonn walked Bonin through the options, which included an open chest operation or a minimally invasive valve replacement. Bonin opted for the minimally invasive TAVR.
Bonin followed restrictions such as no driving for 30 days and not lifting more than 10 pounds and is now back to enjoying the outdoors.
“One of the main things I’ve noticed,” Bonin said, “is I’m sleeping so much better now.”
To learn more about TAVR or same-day discharge, please call 314-251-1700.