Structural Heart Interventions During COVID-19

Area of Science:

• Cardiovascular Medicine
• Public Health Policy
• Infectious Diseases

Background:

• The COVID-19 pandemic necessitated resource conservation and public protection, leading to widespread postponement of non-emergent cardiac procedures.
• Procedures such as transaortic valve replacement (TAVR), left atrial appendage closure (LAAC), MitraClip, and CardioMEMS were significantly impacted by these policies.
• Initial guidelines were based on the potential for adverse clinical outcomes during the pandemic's peak.

Purpose of the Study:

• To review updated guidelines from major cardiovascular societies regarding cardiac procedures during the COVID-19 era.
• To discuss strategies for the safe continuation of advanced cardiac interventions.
• To improve clinical outcomes for high-acuity patients requiring these procedures amidst the pandemic.

Main Methods:

• Review of published guidelines from leading cardiovascular societies.
• Analysis of evolving understanding of SARS-CoV-2 transmission and management.
• Discussion of logistical and clinical coordination strategies for procedural safety.

Main Results:

• Cardiovascular societies have issued new guidelines allowing for the careful resumption of advanced cardiac procedures.
• Enhanced coordination and adherence to safety protocols enable safe performance of TAVR, LAAC, MitraClip, and CardioMEMS.
• The focus is on balancing procedural necessity with infection control measures.

Conclusions:

• Advanced cardiac procedures can be safely performed during the COVID-19 pandemic with appropriate planning and adherence to updated guidelines.
• Careful coordination is essential to mitigate risks and ensure optimal patient outcomes.
• The resumption of these procedures is critical for managing high-acuity cardiovascular conditions.