COVID‐19 and its implications on patient selection for TAVI and SAVR: Are we heading into a new era?

Harky, Amer; Seyedzenouzi, Golnoush; Sanghavi, Ria; Premkumar, Ganeshkumar; Badran, Abdul

doi:10.1111/jocs.15181

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…During the COVID-19 pandemic, the decrease in TAVR and SAVR incidence was associated with higher mortality in patients with severe AS waiting for intervention. In addition, the future management of aortic valve diseases during the COVID-19 pandemic is likely to see an increase in virtual assessments and consultations and the expanded use of TAVI as a treatment option [ 38 ]. The paper by a group from the Royal Papworth Hospital at the University of Cambridge, UK, should serve as concrete proof that SAVR remains an excellent option with favorable outcomes in the treatment of AS [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve Replacement for Long-Term Mortality Due to Stroke and Myocardial Infarction: A Meta-Analysis during the COVID-19 Pandemic

et al. 2022

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Background and objectives: One of the leading causes of mortality and morbidity in people over the age of 50 is stroke. The acceptance of transcatheter aortic valve replacement (TAVR) as a treatment option for severe symptomatic aortic stenosis (AS) has increased as a result of numerous randomized clinical trials comparing surgical aortic valve replacement (SAVR) and TAVR in high- and intermediate-risk patients, showing comparable clinical outcomes and valve hemodynamics. Materials and Methods: An electronic search of Medline, Google Scholar and Cochrane Central was carried out from their inception to 28 September 2022 without any language restrictions. Results: Our meta-analysis demonstrated that, as compared with SAVR, TAVR was not linked with a lower stroke ratio or stroke mortality. It is clear from this that the SAVR intervention techniques applied in the six studies were successful in reducing cardiogenic consequences over time. Conclusions: A significantly decreased rate of mortality from cardiogenic causes was associated with SAVR. Additionally, when TAVR and SAVR were compared for stroke mortality, the results were nonsignificant with a p value of 0.57, indicating that none of these procedures could decrease stroke-related mortality.

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Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve Replacement for Long-Term Mortality Due to Stroke and Myocardial Infarction: A Meta-Analysis during the COVID-19 Pandemic

et al. 2022

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“…Every institution had to define their way of fulfilling the needs of COVID-19 care and non-COVID-19 care. Medical societies helped to define allocation algorithms, and this led to a restructuring of many TAVR programs [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Our heart center started early with the development of an internal allocation algorithm with the aim of offering resources to the patients with urgent need and the ambition of defining patient cohorts who could go on a waiting list without unrecognized deterioration of their disease.…”

Section: Introductionmentioning

confidence: 99%

Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results

Berisha

Klein

Veulemans

et al. 2022

JCDD

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Due to shortages of medical resources during the Coronavirus Disease 2019 (COVID-19) pandemic, an allocation algorithm for Transcatheter Aortic Valve Replacement (TAVR) was established. We investigated the impact on patient selection and procedural results. In total, 456 TAVR patients before (pre-COVID-19 group) and 456 TAVR patients after (COVID-19 group) the implementation of our allocation algorithm were compared. Concerning patient characteristics, the COVID-19 group revealed a higher rate of cardiac decompensations/cardiogenic shocks (10.5% vs. 1.3%; p < 0.001), severe angina pectoris (Canadian Cardiovascular Society (CCS) II, III and IV: 18.7% vs. 11.8%; p = 0.004), troponin elevation (>14 ng/L: 84.9% vs. 77%; p = 0.003) and reduced left ventricular ejection fraction (LVEF) (<45%: 18.9% vs. 12%; p = 0.006). Referring to procedural characteristics, more predilatations (46.3% vs. 35.1%; p = 0.001) and a longer procedural time (80.2 min (+/−29.4) vs. 66.9 min (+/−17.5); p < 0.001) were observed. The success rate was evenly high; no differences in safety parameters were reported. Examining the utilization of hospital resources, the COVID-19 group showed a shorter in-hospital stay (8.4 days (+/−5.9) vs. 9.5 days (+/−9.33); p = 0.041) and fewer TAVR patients were treated per month (39 (+/−4.55) vs. 46.11 (+/−7.57); p = 0.03). Our allocation algorithm supported prioritization of sicker patients with similar efficient and safe TAVR procedures. In-hospital stay could be shortened.

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Safety and Feasibility of Transcatheter Aortic Valve Replacement in COVID-19 Patients: A Case Series

Giacomin

Barioli

Favero

et al. 2021

Cardiovascular Revascularization Medicine

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In 2020, the coronavirus disease 2019 (COVID-19) pandemic has led to a decrease in interventional treatment for structural heart disease worldwide. In this context, the management of patients with symptomatic severe aortic stenosis (AS) or bioprosthetic valve dysfunction (BVD) represents a clinical challenge, as a delay in aortic valve replacement procedures may increase short-term morbidity and mortality. We report four cases of TAVR performed in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. All of them were discharged in good clinical conditions and no adverse events were reported at 30 days follow-up. Our experience suggests that in selected patients with mild SARS-CoV-2 infection and symptomatic native AS or BVD, TAVR has a favorable short-term outcome.

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COVID‐19 and its implications on patient selection for TAVI and SAVR: Are we heading into a new era?

Cited by 4 publications

References 21 publications

Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve Replacement for Long-Term Mortality Due to Stroke and Myocardial Infarction: A Meta-Analysis during the COVID-19 Pandemic

Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve Replacement for Long-Term Mortality Due to Stroke and Myocardial Infarction: A Meta-Analysis during the COVID-19 Pandemic

Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results

Safety and Feasibility of Transcatheter Aortic Valve Replacement in COVID-19 Patients: A Case Series

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