✓ Careful ultrasound-guided femoral puncture and successful percutaneous closure

✓ Local anaesthesia and light sedation (awake at the time of transfer)

✓ Non-compressive dressing to facilitate easy visualization, monitoring of puncture sites and haemostasis, and early identification of bleeding

□ Location of femoral vascular access lines (arterial and venous)

□ Vascular access and closure (including peri-procedure vascular problems)

□ Appropriateness for 4 h mobilization protocol (e.g. vascular access, haemodynamic/neurological status)

□ Cardiac rhythm (including any conduction problems since valve deployment)

□ Anticipated recovery trajectory (including anticipation of any complications)

- Patient education of mobilization time points and targets

- Established protocol for monitoring heart rate, blood pressure, heart rate, neurological status, and vascular access: every 15 min × 4, every 30 min × 4, and every hour × 2

- Concurrent assessment of vascular access sites/dressing with visualization and peripheral perfusion (i.e. colour, warmth, movement, and sensitivity)

- Head of the bed flat × 2 h; then, elevate to 30°

- Confirmed stable clinical status and haemostasis (note: minor serosanguinous oozing may be acceptable pending clinical assessment)

- Progressive ‘mobilization to elimination’: nurse-led assistance to standing position with target of ambulation to toilet

- Monitoring and early identification of possible vasovagal reaction; consider two-person assistance as required for initial ambulation

- Up in chair for evening meal

- Additional ambulation × 1 or 2

- Promotion of hydration, nutrition, elimination, and self-care behaviour as appropriate

- Ambulation × 1–2 during morning activities

- Confirmed return to baseline mobilization

- Confirmed criteria-based readiness for next day discharge¹⁹