Procedural outcomes
All 111 patients in the 2020 cohort underwent preoperative COVID-19
nasal polymerase chain reaction (PCR) testing, of whom 1 (0.9%)
asymptomatic patient tested positive. Following detailed discussion of
risks and benefits with patient and healthcare staff, the procedure was
completed in this patient without acute complication. COVID-19 nasal PCR
testing was performed on the day of the procedure in 29 of 111 patients
(26%), and 1-3 days prior to the procedure in 82 of 111 patients
(74%). At 30 days follow-up, 0 of 110 (0%) patients of 2020 cohort
were diagnosed with new COVID-19 infection. Fewer patients underwent
preoperative TEE in 2020 compared to 2019 (76 of 111 patients (68.4%)
vs. 195 of 200 patients (97.5%), respectively, p<.001).
Same day discharge was achieved in 76 of 111 patients (68.4%) in the
2020 cohort compared to 0 of 200 patients (0%) in the 2019 cohort.
Overnight observation was required in 35 of 111 patients (31.6%)
patients. The most common reason for overnight observation was late
procedure end time (n = 13, Table 3). Median 2020 cohort in-hospital
time was significantly shorter than that of the 2019 cohort (12h [IQR
11h – 26h] vs. 29h [IQR 28h – 31h], p < 0.001, Figure
1).
There were no major complications in either cohort, and there was no
significant difference in overall procedure-related complications at 30
days between the 2020 cohort and the 2019 cohort (5.4% and 4.5%
respectively, p=0.71, Table 2). Two patients (2%) developed heart
failure exacerbation requiring hospitalization or emergency room visit
in the 2020 cohort compared to 3 patients (1.5%) in the 2019 cohort
(p=0.83).