Transcatheter Aortic Valve Replacement in the Coronavirus Disease 2019 (COVID‐19) Era

Mentias, Amgad; Jneid, Hani

doi:10.1161/jaha.120.017121

Cited by 11 publications

(14 citation statements)

References 18 publications

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“…Mentias et al. [ 5 ] recently proposed an algorithm for the timing of TAVI based on the health status of the patients and following the urgency of the procedure, which in our opinion could be used as a guideline in these unusual times.…”

Section: Discussionmentioning

confidence: 99%

Ongoing transcatheter aortic valve implantation (TAVI) practice amidst a global COVID-19 crisis: nurse-led analgesia for transfemoral TAVI

et al. 2020

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The current coronavirus disease 2019 (COVID-19) crisis has led to a relative unavailability of anaesthesiological support for non-acute cardiac care. Currently, transfemoral transcatheter aortic valve implantation (TF-TAVI) is predominantly performed as an elective catheterisation laboratory (cath lab) procedure. Hence, the performance of TAVI could come to a halt amidst the COVID-19 crisis. Our study population comprised 90 patients treated with TF-TAVI, with local analgesia performed by our dedicated cath lab nurses. The patients had a mean age of 80 ± 5 years and 59% were male, with a predicted surgical risk of 2.2 ± 0.9/3.1 ± 2.4% (Society of Thoracic Surgeons Predicted Risk of Mortality [STS-PROM] score/EuroSCORE II), depicting a contemporary, lower-risk population. The composite endpoint of device success (Valve Academic Research Consortium [VARC]-2) was reached in all patients. No patients showed more than mild paravalvular leakage (3/90, 3.3%). Overall, intravenous medication was sparsely used during the procedure, with 48 of the 90 (53%) patients receiving no unplanned intravenous medication. There was neither procedural nor in-hospital mortality. The performance of TF-TAVI using local analgesia only, managed by a dedicated nurse instead of an anaesthesiologist, was shown to be feasible and safe in a selected group of patients. This strategy may (temporarily) eliminate the need for an anaesthesiologist to be present in the cath lab and enables ongoing TAVI treatment amidst the global COVID-19 crisis.

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Section: Discussionmentioning

confidence: 99%

Ongoing transcatheter aortic valve implantation (TAVI) practice amidst a global COVID-19 crisis: nurse-led analgesia for transfemoral TAVI

et al. 2020

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“…Mortality of COVID-19 is increased in the elderly with comorbidities and/or pre-existing cardiac conditions, raising concerns on the risk-benefit ratio of VHD treatment vs. COVID-19 nosocomial infection. 10 Moreover, VHD interventions usually require numerous investigations and physicians contacts, thus increasing the risk of COVID-19 infection. Finally, some patients cancelled procedures on their own, due to fears of contracting the coronavirus and/or the family isolation due to restrictive hospital visitation policies.…”

Section: Peak Of the Covid-19 Pandemic: Care Of Heart Failure Patientmentioning

confidence: 99%

“…In emergent situations, balloon aortic valvuloplasty may be considered as a bridge to TAVI or surgery. 10 TAVI remains an off-label procedure for patients with aortic regurgitation (AR), though it has been reported as feasible and effective. In patients with severe AR who need high-priority intervention, the Heart Team may figure out TAVI rather than surgery preferably in expert centres.…”

Section: Procedural Aspectsmentioning

confidence: 99%

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Patient with heart failure: importance to treat valvular diseases

Adamo

Alos

Metra

et al. 2020

European Heart Journal Supplements

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COVID-19 pandemic is causing an unprecedented burden on healthcare resources and this includes treatment of heart failure and valvular heart diseases (VHD). Percutaneous procedures have broadened the number of patients with VHD who could be treated. However, COVID-19 pandemic has challenged their implementation. The risk of in-hospital infection, resources reallocation, reduced access to hospital caused a substantial delay of VHD treatment with an increased risk of clinical worsening and mortality. Now, the pandemic is not ended and subsequent waves are likely. Reorganization of our healthcare resources is needed, including a proper algorithm for patients’ prioritization, based on the severity of their valve disease, their life expectancy, complexity of the intervention, and the resources available. A wider use of telemedicine for patients’ selection and follow-up and any measurement that can shorten the duration of the hospital stay must be adopted. Patients’ and healthcare staff screening for COVID-19 and all needed procedures to prevent infection will continue to be mandatory. Percutaneous procedures, compared to surgery, are associated with a lower risk of infection and a lower need for in-hospital resources, including a shorter duration of hospital stay. This may favour their adoption when the risk of viral infection is high.

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“…That is the case of trans-catheter aortic valve implantation (TAVI) [ 3 ], that is frequently indicated in patients with limited life expectancy if left untreated. Because of that, some recommendations about TAVI procedure during pandemic have been published [ [4] , [5] , [6] , [7] ], including those recently published by Khan and co-workers [ 8 ]. These documents have included recommendations related with patient selection, health care workers protection and also technical and procedural instructions in order to reduce hospital stay (i.e.…”

mentioning

confidence: 99%

Transcatheter Aortic Valve Implantation During COVID-19 Pandemic: The Device Also Matters

Gonzálvez-García

Jiménez‐Valero

Jurado-Román

et al. 2021

Cardiovascular Revascularization Medicine

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Transcatheter Aortic Valve Replacement in the Coronavirus Disease 2019 (COVID‐19) Era

Cited by 11 publications

References 18 publications

Ongoing transcatheter aortic valve implantation (TAVI) practice amidst a global COVID-19 crisis: nurse-led analgesia for transfemoral TAVI

Ongoing transcatheter aortic valve implantation (TAVI) practice amidst a global COVID-19 crisis: nurse-led analgesia for transfemoral TAVI

Patient with heart failure: importance to treat valvular diseases

Transcatheter Aortic Valve Implantation During COVID-19 Pandemic: The Device Also Matters

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