Safety and Outcomes of Same-Day Discharge After Elective Cardiac Catheterization for Congenital Heart Disease: A Single-Center Propensity-Matched Cohort Study.

BACKGROUND: Overnight observation remains the conventional disposition after elective catheterization for congenital heart disease, although most elective procedures can be performed without significant complication. We evaluated the safety of same-day discharge (SDD) after elective congenital cardiac catheterization at a single tertiary center. AIMS: We aimed to evalute the safety and outcomes of same-day discharge (SDD) after elective cardiac catheterization for congenital heart disease at a single tertiary center and to compare SDD with overnight admission using propensity score matching. METHODS: We performed a retrospective cohort study of elective catheterizations between January 2023 and April 2026. Patients discharged home the same day (same-day discharge, SDD, n = 54) were compared with patients admitted for at least one night (delayed discharge, DD, n = 551) following elective procedures. Outcomes included in-hospital adverse events and, for the SDD cohort, 30-day emergency department (ED) visits and readmissions. A 1:1 propensity score-matched analysis (age, weight, sex, oxygen saturation, hemoglobin, and interventional procedure) was performed. RESULTS: SDD patients were older (median 10.4 vs. 3.9 years, p < 0.001), larger (31.0 vs. 14.9 kg, p < 0.001), less often underwent an interventional procedure (42.6% vs. 78.7%;p < 0.001), and shorter procedure duration (64 vs. 111 min, p < 0.001) as compared to the admission group. Median post-procedure observation was 6.1 h (IQR, 5.1-7.0) and total facility time 10.5 h (IQR). No in-hospital adverse events occurred among SDD patients, compared with 36 (5.9%) DD patients (p = 0.11). Within 30 days of SDD, 2 patients (3.7%) had an ED visit and 4 (7.4%) were readmitted (6 encounters); one readmission (1.9%) was procedure-related, a femoral pseudoaneurysm managed under observation. In 52 matched pairs, no in-hospital adverse events occurred in either group; median length of stay was 0 versus 1 day (p < 0.001); and 30-day all-cause readmission occurred in 3 (5.8%) SDD versus 6 (11.5%) DD cohorts (p = 0.054). CONCLUSIONS: In carefully selected, predominantly lower-risk patients, SDD after elective congenital cardiac catheterization was not associated with in-hospital adverse events or excess procedure-related 30-day morbidity. SDD may safely reduce hospital resource utilization in this population; however, the small sample size, selection bias, and residual confounding limit conclusions regarding broader safety or equivalence with overnight observation.