Coronary and Structural Heart Disease Interventions During COVID-19 Pandemic: A Road Map for Clinicians and Health Care Delivery Systems

Harjai, Kishore J.; Agarwal, Shikhar; Bauch, Terry D.; Bernardi, Mark; Casale, Alfred S.; Green, Sandy; Harostock, Michael; Ierovante, Nicholas; Mascarenhas, Vernon; Matsumura, Martin E.; Nawaz, Yassir; Scott, Thomas R.; Singh, Deepak; Stella, Joseph; Vijayaraman, Pugazhendi; Yost, Gregory; Blankenship, James C.

doi:10.1016/j.carrev.2020.06.013

Cited by 9 publications

(9 citation statements)

References 9 publications

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“…5 There is a need to protect patients from exposure to this virus during these periods of uncertainty. 58 During the first wave of the pandemic, the highest risk patients were prioritized for review, but now, we are at the recovery phase, and both high-risk and intermediate-risk patient care need initiation to minimize disease progression. 59 Optimizing community HF services during the recovery from the pandemic has the potential to reduce the pressures on secondary care.…”

Section: Heart Failure Hospitalizationmentioning

confidence: 99%

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

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Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. The clinical presentation of this virus mainly manifests in the respiratory system but may also lead to severe complications in the cardiovascular system. The global burden of COVID-19 has led to an unprecedented need to gain further insight into patient outcomes, management, and clinical practice. This review aims to provide an overview of the current literature on heart failure (HF) hospitalizations, management, and care pathways for supporting patients during and beyond this pandemic. A literature review of five areas of interest was conducted and included: (i) HF hospitalization; (ii) recognizing the needs and supporting HF patients during COVID-19; (iii) supporting rehabilitation services; (iv) transitioning to a telehealth framework; and (v) the need for evidence. Patients with new-onset or existing HF are particularly vulnerable, but a significant reduction in HF hospital admissions has been reported. During these periods of uncertainty, the current care pathways for acute and elective cardiac patients have had to change with the relocation of HF services to protect the vulnerable and reduce transmission of COVID-19. Optimizing community HF services has the potential to reduce the pressures on secondary care during the recovery from this pandemic. Telemedicine and virtual health care are emerging technologies and overcome the risk of in-person exposure. Successful remote delivery of cardiac rehabilitation services has been reported during the pandemic. Delivery of a robust telehealth framework for HF patients will improve communication between clinician and patient. The reduction in HF admissions is a concern for the future and may result in unintended mortality. New-onset and current HF patients must understand their diagnosis and future prognosis and seek help and support using the appropriate platform when needed. Realigning HF services and the use of telemedicine and virtual health care has great potential but needs to be carefully understood to ensure engagement and approval in this population to overcome barriers and challenges.

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Section: Heart Failure Hospitalizationmentioning

confidence: 99%

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

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“…The true impact of severe valvular heart disease in patients with COVID-19 has not described in the literature so far. 3,9,10 Nevertheless, it is clear that patients with severe valvular heart disease often tend to be multimorbid and frail and have a higher mortality rate compared with the normal population. 3 With future data and research, it will become clear that the prognosis of patients with the combination of COVID-19 and severe valvular heart disease will be poor.…”

Section: Discussionmentioning

confidence: 99%

MitraClip Insertion to Hasten Recovery from Severe COVID-19

Nagaraja¹,

Wang²,

Harb³

et al. 2021

CASE

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Highlights Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome (SARS) coronavirus 2 has affected 188 countries worldwide with a global death toll of over half a million Patients with valvular heart disease are also at an increased risk of adverse outcomes from coronavirus disease-2019 Prognosis of patients with the combination of COVID 19 and severe valvular heart disease is poor This is the first reported case of MitraClip insertion in a patient with severe COVID 19 infection. This procedure assisted in the patient’s recovery relieving his cardiac burden and pulmonary edema enabling him to undergo colorectal surgery.

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“…However, more than half of the studied papers are just reviews of the relevant literature and do not provide a practical model. For example, in heart clinics, Harjai et al [ 16 ] surveyed the physicians and provided viewpoints from mangers to study the improvement possibility of patient workflow, theoretically. Similarly, Virani et al [ 3 ] reviewed the activities performed for heart failure care during the COVID-19 outbreak and provided viewpoints from leadership within the Canadian Heart Failure Society.…”

Section: Literature Reviewmentioning

confidence: 99%

“…In the healthcare field, there is a need to achieve optimal waiting times in clinical workflow and identify and resolve bottlenecks [ 2 ]. The COVID-19 pandemic forces clinics to modify their workflows for urgent patients [ 16 ]. Particularly, this virus has posed many challenges for heart clinics.…”

Section: Introductionmentioning

confidence: 99%

Simulation and Improvement of Patients’ Workflow in Heart Clinics during COVID-19 Pandemic Using Timed Coloured Petri Nets

Zeinalnezhad

Chofreh

Goni

et al. 2020

IJERPH

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The COVID-19 epidemic has spread across the world within months and creates multiple challenges for healthcare providers. Patients with cardiovascular disease represent a vulnerable population when suffering from COVID-19. Most hospitals have been facing difficulties in the treatment of COVID-19 patients, and there is a need to minimise patient flow time so that staff health is less endangered, and more patients can be treated. This article shows how to use simulation techniques to prepare hospitals for a virus outbreak. The initial simulation of the current processes of the heart clinic first identified the bottlenecks. It confirmed that the current workflow is not optimal for COVID-19 patients; therefore, to reduce waiting time, three optimisation scenarios are proposed. In the best situation, the discrete-event simulation of the second scenario led to a 62.3% reduction in patient waiting time. This is one of the few studies that show how hospitals can use workflow modelling using timed coloured Petri nets to manage healthcare systems in practice. This technique would be valuable in these challenging times as the health of staff, and other patients are at risk from the nosocomial transmission.

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Coronary and Structural Heart Disease Interventions During COVID-19 Pandemic: A Road Map for Clinicians and Health Care Delivery Systems

Cited by 9 publications

References 9 publications

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

MitraClip Insertion to Hasten Recovery from Severe COVID-19

Simulation and Improvement of Patients’ Workflow in Heart Clinics during COVID-19 Pandemic Using Timed Coloured Petri Nets

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