Transcatheter aortic valve implantation during the COVID-19 pandemic:
clinical expert opinion and consensus statement for Asia.
Abstract
Objectives The impact of the COVID 19 pandemic on the treatment of
patient with aortic valve stenosis is unknown and there is uncertainty
on the optimal strategies in managing these patients. Methods This study
is supported and endorsed by the Asia Pacific Society of Interventional
Cardiology. Due to the inability to have face to face discussions during
the pandemic, an online survey was performed by inviting key opinion
leaders ( cardiac surgeon/interventional cardiologist/echocardiologist)
in the field of transcatheter aortic valve implantation (TAVI) in Asia
to participate. The answers to a series of questions pertaining to the
impact of COVID-19 on TAVI were collected and analyzed. These led
subsequently to an expert consensus recommendations on the conduct of
TAVI during the pandemic Results The COVID 19 pandemic had resulted in a
25% (10-80) reduction of case volume and 53% of operators required
triaging to manage their patients with severe aortic stenosis. The two
most important parameters used to triage were symptoms and valve area.
Periprocedural changes included the introduction of teleconsultation,
pre-procedure COVD 19 testing, optimization of pre-tests and
catheterization laboratory set up. In addition, length of stay was
reduced from a mean of 4.4 to 4 days. Conclusion The COVID-19 pandemic
has impacted on the delivery of TAVI services to patients in Asia. This
expert recommendations on best practices may be a useful to guide to
help TAVI teams during this period until a COVID 19 vaccine becomes
widely available