Transcatheter Aortic Valve Replacement Outcomes During the Public Health Emergency Flexibility Period

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Public Health Policy

Background:

• The COVID-19 public health emergency (PHE) introduced flexibilities in healthcare delivery.
• Transcatheter aortic valve replacement (TAVR) is a critical procedure for aortic stenosis.
• Assessing TAVR outcomes during the PHE is crucial for understanding its impact on patient care.

Purpose of the Study:

• To compare transcatheter aortic valve replacement (TAVR) outcomes during the PHE period with flexibilities against a pre-PHE period.
• To evaluate the safety and efficacy of TAVR under altered regulatory and operational conditions.

Main Methods:

• A retrospective analysis of the STS/ACC Transcatheter Valve Therapy Registry (2019-2022).
• Two cohorts were created: pre-PHE and peri-PHE, with 1:1 propensity score matching.
• In-hospital and 30-day post-TAVR outcomes were compared, including mortality, stroke, and complications.

Main Results:

• 173,434 patients met inclusion criteria; 37,063 patients were matched in each cohort.
• No significant differences were observed in in-hospital outcomes (mortality, stroke, pacemaker, vascular complications) between the cohorts.
• Similarly, 30-day post-TAVR outcomes showed no statistically significant differences between the pre-PHE and peri-PHE periods.

Conclusions:

• TAVR procedures performed during the PHE period demonstrated comparable outcomes to those performed before the PHE.
• The findings suggest that PHE flexibilities did not negatively impact TAVR safety or efficacy.
• This large-scale study supports the continued use and potential adaptation of TAVR procedures during public health crises.