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Safety and Feasibility of Transcatheter Aortic Valve Replacement in COVID-19 Patients: A Case Series
Enrico Giacomin1, Alberto Barioli2, Luca Favero2
1Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy; Department of Cardiac, Vascular, Thoracic Sciences and Public Health, University of Padua, Italy.
Insights
Transcatheter aortic valve replacement (TAVR) is a safe option for patients with severe aortic stenosis and mild COVID-19. This approach offers a favorable short-term outcome, even during the pandemic.
Area of Science:
- Cardiology
- Interventional Cardiology
- Infectious Diseases
Background:
- The COVID-19 pandemic disrupted structural heart disease interventions globally.
- Managing severe aortic stenosis (AS) or bioprosthetic valve dysfunction (BVD) became challenging due to delayed aortic valve replacement, increasing patient risk.
- Transcatheter aortic valve replacement (TAVR) emerged as a potential solution for high-risk patients.
Observation:
- Four cases of TAVR were successfully performed in patients with active SARS-CoV-2 infection.
- All patients had mild SARS-CoV-2 infection and symptomatic severe AS or BVD.
- Patients were discharged in good clinical condition.
Findings:
- No adverse events were reported at 30-day follow-up for any of the TAVR procedures.
- The study suggests TAVR is feasible and safe in selected patients with mild SARS-CoV-2 infection.
- Favorable short-term outcomes were observed in this cohort.
Implications:
- TAVR can be considered a viable treatment option for symptomatic severe AS or BVD patients with mild COVID-19.
- This approach may help mitigate risks associated with delayed interventions during pandemics.
- Further research is warranted to confirm long-term outcomes and expand patient selection criteria.
Abstract:
In 2020, the coronavirus disease 2019 (COVID-19) pandemic has led to a decrease in interventional treatment for structural heart disease worldwide. In this context, the management of patients with symptomatic severe aortic stenosis (AS) or bioprosthetic valve dysfunction (BVD) represents a clinical challenge, as a delay in aortic valve replacement procedures may increase short-term morbidity and mortality. We report four cases of TAVR performed in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. All of them were discharged in good clinical conditions and no adverse events were reported at 30 days follow-up. Our experience suggests that in selected patients with mild SARS-CoV-2 infection and symptomatic native AS or BVD, TAVR has a favorable short-term outcome.
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