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Managing Severe Aortic Stenosis in the COVID-19 Era
Varsha K Tanguturi1, Brian R Lindman2, Philippe Pibarot3
1Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Insights
Strategies for managing severe aortic stenosis during the COVID-19 pandemic focus on reducing patient exposure and healthcare resource use. Innovations include remote monitoring and virtual care to maintain patient outcomes during this public health crisis.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic presents challenges for managing severe aortic stenosis.
- Patients with severe aortic stenosis have high mortality risk, often overlapping with high-risk COVID-19 populations.
- Treatment delays for aortic stenosis can lead to adverse outcomes.
Purpose of the Study:
- To outline management strategies for severe aortic stenosis patients during the COVID-19 pandemic.
- To balance patient safety, resource allocation, and clinical outcomes.
- To adapt cardiovascular care during a public health emergency.
Main Methods:
- Transitioning to virtual patient assessments and consultations.
- Optimizing and streamlining diagnostic testing.
- Reducing hospital admission frequency and duration.
- Implementing remote monitoring and telehealth services.
Main Results:
- Proposed strategies aim to minimize COVID-19 exposure for patients and healthcare workers.
- Resource utilization is optimized without compromising patient outcomes.
- Innovations facilitate remote patient monitoring and virtual rehabilitation.
Conclusions:
- Effective management of severe aortic stenosis is achievable during the COVID-19 pandemic.
- Virtual care and remote monitoring are key innovations.
- These strategies preserve patient outcomes while conserving resources.
Abstract:
The novel coronavirus disease-2019 (COVID-19) pandemic has created uncertainty in the management of patients with severe aortic stenosis. This population experiences high mortality from delays in treatment of valve disease but is largely overlapping with the population of highest mortality from COVID-19. The authors present strategies for managing patients with severe aortic stenosis in the COVID-19 era. The authors suggest transitions to virtual assessments and consultation, careful pruning and planning of necessary testing, and fewer and shorter hospital admissions. These strategies center on minimizing patient exposure to COVID-19 and expenditure of human and health care resources without significant sacrifice to patient outcomes during this public health emergency. Areas of innovation to improve care during this time include increased use of wearable and remote devices to assess patient performance and vital signs, devices for facile cardiac assessment, and widespread use of clinical protocols for expedient discharge with virtual physical therapy and cardiac rehabilitation options.
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