Transcatheter aortic valve implantation during COVID-19 pandemic: An optimized model to relieve healthcare system overload

Abstract

Background The coronavirus 2019 (COVID-19) pandemic upset healthcare systems and their logistics worldwide. We sought to assess safety and effectiveness of an optimized logistics for transcatheter aortic valve implantation (TAVI) pathway developed during the COVID-19 pandemic. Methods This is a retrospective analysis. An optimized TAVI logistics based on performing TAVI work-up and procedure during the same hospitalization was used during the COVID-19 pandemic. In-hospital and 30-day outcomes of patients treated during the pandemic were compared with an historical cohort of patients undergoing TAVI with staged work-up before the pandemic within an homogeneous timeframe. Results Of 536 patients, 227 (42.4%) underwent TAVI during the COVID-19 pandemic with a reduction of 26.5% compared to the pre-pandemic period ( n = 309). The median age was 81 (77–85) years and STS score was 3.4 (2.2–5.6)%. Lower rates of in-hospital major vascular complications (2.2% vs. 8.7%; p < 0.01) and life-threatening bleeding (0.4% vs. 4.2%; p = 0.01) were reported in the COVID-19 period, whereas no difference in acute kidney injury (7.0% vs. 7.4%, p = 0.85) rate was reported between COVID-19 and pre-COVID-19 periods. No difference in 30-day rates of all-cause death (4.0 vs. 4.5, p = 0.75) and of major adverse cardiovascular events (4.0 vs. 6.1, p = 0.26) were reported between COVID-19 and pre-COVID-19 periods. Conclusions The use of optimized single-hospitalization logistics for TAVI workup and procedure developed during the COVID-19 pandemic, showed to be as safe and effective as the two-stage TAVI pathway previously adopted, allowing the minimization of potential exposure to COVID-19 infection and shortening times to treatment for severely symptomatic patients.

A streamlined pathway for transcatheter aortic valve implantation: the BENCHMARK study

“…However, although one may expect a prolonged length of hospital stay, several studies have shown that the LoS in TAVI patients was either comparable or shorter during the COVID-19 pandemic compared with the pre-pandemic period. 23–27 Thus, we may only speculate that the pandemic itself had an effect on the TAVI LoS and outcomes in patients in either phase.…”

Understanding coronavirus disease 2019 (COVID-19) vaccine hesitancy: Evidence from the community-driven knowledge site Quora

“…More than 6 million people have died of the disease, and the number of confirmed cases is more than 540 million as of June 2022. 1 The healthcare system has been overloaded, 2 , 3 and many people have experienced financial hardship 4 , 5 and depression. 6 …”

“…More than 6 million people have died of the disease, and the number of confirmed cases is more than 540 million as of June 2022. 1 The healthcare system has been overloaded, 2,3 and many people have experienced financial hardship 4,5 and depression. 6 Thirteen COVID-19 vaccines have been developed, 7 and some (i.e., those manufactured by Pfizer-BioNTech, Moderna, and Janssen) have been approved by the U.S.…”

Stress-testing interventional cardiology organization to streamline procedures during COVID-19 pandemic, and beyond

“…The manuscript by Reddavid et al in this Journal [ 8 ], together with other reports from different countries [ 7 , 9 , 10 ], clearly illustrates how the healthcare system may be readjusted to react to the pandemic adversities. In all cases, efforts were addressed to the following goals: 1) keeping an acceptable waiting period for symptomatic subjects; 2) reducing total hospitalization length; 3) minimizing or even eliminating the need for post-intervention transfer to intensive care unit (ICU), which at times had also been converted into COVID ICUs.…”