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Transcatheter Aortic Valve Implantation During the COVID-19 Pandemic
Martín Valdebenito1, Eias Massalha2, Israel M Barbash2
1Interventional Cardiology Unit, Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Insights
Transcatheter aortic valve implantation (TAVI) is safe and effective during the COVID-19 pandemic. Outcomes like procedural success and 30-day mortality were similar between pandemic and non-pandemic eras, demonstrating TAVI
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Public Health
Background:
- The impact of the COVID-19 pandemic on Transcatheter Aortic Valve Implantation (TAVI) outcomes requires thorough evaluation.
- Some structural heart programs globally experienced suspensions during the pandemic.
- Limited data exists on TAVI safety and efficacy during the COVID-19 pandemic.
Purpose of the Study:
- To evaluate and compare clinical outcomes of TAVI patients during the COVID-19 pandemic versus the pre-pandemic era.
- To assess the safety and effectiveness of TAVI procedures performed under pandemic conditions.
Main Methods:
- A single-center comparative study.
- Compared 198 TAVI patients from 2019 (non-pandemic) with 59 TAVI patients from March 1st to June 30th, 2020 (pandemic).
- Primary outcomes included procedural success (VARC criteria) and 30-day mortality.
Main Results:
- High procedural success rates were observed in both groups (93.3% vs 96.6%, p=0.53).
- No significant differences were found in vascular complications (26% vs 19%, p=0.3), permanent pacemaker implantation (11.8% vs 15.3%, p=0.63), or length of hospital stay (5.2 vs 4.2 days, p=0.29).
- Thirty-day mortality rates were similar between the groups (3% vs 3.4%, p=1.0).
Conclusions:
- Transcatheter aortic valve implantation (TAVI) can be performed effectively and safely during the COVID-19 pandemic.
- Minimalist approaches, early discharge, and strict personal protective equipment protocols support safe TAVI during pandemics.
- No documented COVID-19 cases were observed in patients during the follow-up period.
Abstract:
Transcatheter aortic valve implantation (TAVI) outcomes during the coronavirus disease 2019 (COVID-19) pandemic have not been fully evaluated and some structural programs in the world have been suspended during this period. We sought to evaluate and compare clinical outcomes in patients undergoing TAVI in pandemic versus nonpandemic era. In a single center, we compared 198 TAVI patients performed during 2019 to 59 patients performed during the COVID-19 pandemic period (March 1st to June 30th, 2020). Primary outcome was procedural success according to VARC criteria and 30-day mortality rates. VARC-defined procedural success was high in both groups (93.3% vs 96.6%; p = 0.53). There were no differences in any vascular complications (26% vs 19%; p = 0.3), permanent pacemaker implantation (11.8% vs 15.3%; p = 0.63), and length of hospital stay (5.2 vs 4.2 days; p = 0.29). Thirty-day mortality was similar (3% vs 3.4%; p = 1.0). We had no documented COVID-19 disease in our patients during follow up. In conclusion, TAVI procedures can be performed effectively and safely during the COVID-9 pandemic, using a minimalist approach, early discharge, and by maintaining proper use of personal protective equipment.
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