Transcatheter aortic valve implantation during the COVID-19 pandemic: Clinical expert opinion and consensus statement for Asia

Tay EL 1 , Hayashida K 2 , Chen M 3 , Yin WH 4 , Park DW 5 , Seth A 6 Show all authors , Kao HL 7 , Lin MS 7 , Ho KW 8 , Buddhari W 9 , Chandavimol M 10 , Posas FE 11 , Nguyen QN 12 , Kong W 1 , Rosli MA 13 , Hon J 1 , Firman D 14 , Lee M 15

Affiliations 

  • 1 Department of Cardiology and Cardiothoracic and Vascular Surgery, National University Heart Centre, Singapore, Singapore
  • 2 Cardiac Department, Keio University, Tokyo, Japan
  • 3 Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
  • 4 Cardiac Department, Cheng Hsin General Hospital, Taipei, Taiwan
  • 5 Department of Cardiology, Asan Medical Centre, Seoul, South Korea
  • 6 Department of Cardiology, Fortis Escorts Heart Institute, New Delhi, India
  • 7 Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 8 Department of Cardiology, National Heart Centre, Singapore
  • 9 Cardiac Center, Division of Cardiology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • 10 Cardiac Department, Ramathibodi Hospital, Bangkok, Thailand
  • 11 St Lukes Medical Center, Manila, Philippines
  • 12 Vietnam National Heart Institute, Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
  • 13 Cardiac Vascular Sentral Kuala Lumpur, Kuala Lumpur, Malaysia
  • 14 Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • 15 Department of Cardiology, Queen Elizabeth Hospital, Kowloon, Hong Kong
J Card Surg, 2020 Sep;35(9):2142-2146.
PMID: 32720374 DOI: 10.1111/jocs.14722

Abstract

OBJECTIVES: The impact of the COVID-19 pandemic on the treatment of patient with aortic valve stenosis is unknown and there is uncertainty on the optimal strategies in managing these patients.

METHODS: This study is supported and endorsed by the Asia Pacific Society of Interventional Cardiology. Due to the inability to have face to face discussions during the pandemic, an online survey was performed by inviting key opinion leaders (cardiac surgeon/interventional cardiologist/echocardiologist) in the field of transcatheter aortic valve implantation (TAVI) in Asia to participate. The answers to a series of questions pertaining to the impact of COVID-19 on TAVI were collected and analyzed. These led subsequently to an expert consensus recommendation on the conduct of TAVI during the pandemic.

RESULTS: The COVID-19 pandemic had resulted in a 25% (10-80) reduction of case volume and 53% of operators required triaging to manage their patients with severe aortic stenosis. The two most important parameters used to triage were symptoms and valve area. Periprocedural changes included the introduction of teleconsultation, preprocedure COVID-19 testing, optimization of protests, and catheterization laboratory set up. In addition, length of stay was reduced from a mean of 4.4 to 4 days.

CONCLUSION: The COVID-19 pandemic has impacted on the delivery of TAVI services to patients in Asia. This expert recommendation on best practices may be a useful guide to help TAVI teams during this period until a COVID-19 vaccine becomes widely available.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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