Heart Procedure Has Successful Same-Day Discharge at Mercy During Pandemic Freeing Up Hospital Beds

    By Kathleen Berger, Executive Producer for Science & Technology

     “I should have had this procedure a long time ago,” said Dick Bonin.

    Bonin had a heart procedure at Mercy Hospital St. Louis, which used to be a big deal as it would require a lengthy hospital stay. But for Bonin, his Transcatheter Aortic Valve Replacement (TAVR) was different.

    “Luckily I got to go home,” he said.

    He went in at 6 a.m. for the 90 minute procedure and was home by 6p.m. Bonin became the first TAVR same day discharged patient in the St. Louis area.

    “The procedure basically involves using a stented valve that’s mounted on a balloon where we actually insert it into the body, the thermal artery, and deliver it to the heart,” said Dr. Anthony Sonn, Mercy Clinic interventional cardiologist and Mercy Hospital St. Louis TAVR program director. “It’s basically to treat patients with a narrowed aortic valve which is a very common issue that we see, especially in older individuals. “

    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, according to Mercy, the hospital is the first in the St. Louis metropolitan area to offer certain patients the opportunity to have it done and be home the same day. Currently, same-day discharge is only offered at Mercy Hospital St. Louis in the St. Louis area.

    “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. Sonn. “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.”

    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.

    “So because of COVID, it kind of initiated this approach. We really felt like this was something that was good for our patients and it also freed up resources for other patients,” said Dr. Sonn.

    Now Bonin’s back to the outdoor activities he enjoys, saying he feels stronger and healthier.

    “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.

    “My wife and I walk and there’s a hill over here, we call it ‘cardiac hill’. And I had to stop going about halfway up the hill because I was getting a tightness in the chest. And I told the doctor about that when he thought he heard something. That’s when he said, ‘yeah, you’re going in for a stress test.’”

    Bonin said he didn’t realize how badly he needed the procedure until he had it done.

    “I didn’t think I was sick. I didn’t think I had a problem until, especially after the procedure,” Bonin said. “I’m lifting these boards right now and replacing this deck. But I feel 100% better. Sleeping better. I feel like I’ve gained an extra 10 years.”