Cardiac procedural deferral during the coronavirus (COVID‐19) pandemic

Abstract

We aimed to examine factors impacting variability in cardiac procedural deferral during the COVID‐19 pandemic and assess cardiologists' perspectives regarding its implications. Unprecedented cardiac procedural deferral was implemented nationwide during the COVID‐19 pandemic. A web‐based survey was administered by Society for Cardiovascular Angiography and Interventions and the American College of Cardiology Interventional Council to cardiac catheterization laboratory (CCL) directors and interventional cardiologists across the United States during the COVID‐19 pandemic. Among 414 total responses, 48 states and 360 unique cardiac catheterization laboratories were represented, with mean inpatient COVID‐19 burden 16.4 ± 21.9%. There was a spectrum of deferral by procedure type, varying by both severity of COVID‐19 burden and procedural urgency (p < .001). Percutaneous coronary intervention volumes dropped by 55% (p < .0001) and transcatheter aortic valve replacement volumes dropped by 64% (p = .004), with cardiologists reporting an increase in late presenting ST‐elevation myocardial infarctions and deaths among patients waiting for transcatheter aortic valve replacement. Almost 1/3 of catheterization laboratories had at least one interventionalist testing positive for COVID‐19. Salary reductions did not influence procedural deferral or speed of reinstituting normal volumes. Pandemic preparedness improved significantly over time, with the most pressing current problems focused on inadequate testing and staff health risks. During the COVID‐19 pandemic, cardiac procedural deferrals were associated with procedural urgency and severity of hospital COVID‐19 burden. Yet patients did not appear to be similarly influenced, with cardiologists reporting increases in late presenting ST‐elevation myocardial infarctions independent of local COVID‐19 burden. The safety and importance of seeking healthcare during this pandemic deserves emphasis.

North American lower-extremity revascularization and amputation during COVID-19: Observations from the Vascular Quality Initiative

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The Effect of COVID-19 on Adult Cardiac Surgery in the United States in 717 103 Patients

“…[21][22][23] This final consideration is strengthened and is especially concerning because of reportedly increased rates of late presenting ST-elevation myocardial infarctions and associated mechanical complications during the pandemic that are independent of local COVID-19 case volumes. 24 Collectively, these various mechanisms may account for some lack of a rebound in surgical case volumes after April 2020. However, the inability to clearly account for these patients, particularly the large number of where cardiac case volume reductions preceded regional peaks in COVID-19 cases.…”

Fault Lines in India’s COVID-19 Management: Lessons Learned and Future Recommendations

“…Ref: [189][190][191][192] Social media Engage social media platforms to spread awareness and disease prevention Ref: [193,194] Risk Management and Healthcare Policy 2021:14 Oncology care, 148,149 planned surgeries 150,151 cardiovascular intervention 152,153 kidney failure and dialysis, 154,155 to name a few, that were all severely affected, leading to an increase in the death count. As a country, India needs to chalk out plans to ensure that parallel healthcare services continue in pandemic times so that non-COVID patients are not left aside.…”