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Time From First Contact With Heart Team to Transcatheter Aortic Valve Replacement in the COVID-19 Era

Matthew J Billy1, Zachary Brennan2, Tariq Ahmad3

  • 1General Surgery, Geisinger Commonwealth School of Medicine, Scranton, USA.

Cureus
|August 14, 2023
PubMed

Insights

The COVID-19 pandemic significantly delayed transcatheter aortic valve replacement (TAVR) procedures, increasing patient mortality. Healthcare institutions must create strategies to maintain TAVR access during crises to prevent harm.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Public Health

Background:

  • Transcatheter aortic valve replacement (TAVR) is the leading method for aortic valve replacement in the U.S.
  • The COVID-19 pandemic disrupted elective surgical care, impacting TAVR accessibility.
  • Understanding the pandemic's effect on TAVR access and outcomes is crucial.

Purpose of the Study:

  • To evaluate the impact of COVID-19 waves on TAVR procedural timing.
  • To assess the association between COVID-19 waves and TAVR patient outcomes.
  • To identify the need for robust healthcare access mechanisms during public health crises.

Main Methods:

  • Retrospective review of a prospectively maintained database and institutional TAVR data.
  • Comparison of time to TAVR before and during defined COVID-19 waves.
  • Statistical analysis using t-tests to compare pre-COVID-19 and COVID-19 wave data.

Main Results:

  • Mean time to TAVR significantly increased during COVID-19 Wave 1 (68.44 days) and Wave 2 (68.94 days).
  • All three COVID-19 waves showed a significant increase in post-operative all-cause mortality compared to pre-COVID-19 levels.
  • Increased time to TAVR correlates with higher morbidity and mortality, as supported by existing literature.

Conclusions:

  • COVID-19 significantly prolonged TAVR procedure times and elevated mortality rates.
  • Healthcare institutions need proactive strategies to ensure continuous TAVR access during crises.
  • Maintaining timely TAVR access is vital to prevent adverse patient outcomes during pandemics.
Abstract

Keywords:
covid-19 delay of carecovid-19 in surgical patientstavrtime to tavrtranscatheter aortic valve replacement

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