E-8 | Impact of COVID-19 Pandemic on Clinical Outcomes of Transcatheter Aortic Valve Implantation: A Meta-Analysis

The coronavirus disease 2019 (COVID-19) globally impacted healthcare delivery and patient outcomes. Transcatheter aortic valve replacement (TAVR) outcomes during the pandemic are yet to be well described. We aim to compare clinical outcomes in patients who underwent TAVR during the pandemic and pre-pandemic period. We searched PubMed, Scopus, and Google Scholar for TAVR outcome studies during the COVID-19 pandemic Vs pre-pandemic period. Primary outcomes included 30-day all-cause mortality(ACM), Cardiovascular(CV) mortality and stroke. A binary random-effects model calculated a pooled odds ratio (OR) with 95% CI, and I2 statistics to assess heterogeneity. Leave-one-out sensitivity analysis and subgroup analysis were conducted. We included 9 studies involving 6250 patients, mean age of 80 ± 4.6, 48% male, with a 30-day post-TAVR follow-up. Pandemic patients exhibited higher risk factors including stroke and CAD. Patients undergoing TAVR during the pandemic demonstrated comparable rates of 30-day ACM (3% vs. 2.5%, 95% CI: 0.53-1.04, P=0.08), CV mortality (2.8% vs. 2.3%, 95% CI: 0.42- 1.28, P=0.28), stroke (3.1% vs. 2.8%, 95% CI: 0.63-1.2, P=0.41), and vascular complications (8.2% vs. 8.1%, 95% CI: 0.88-1.31, P=0.48). Significantly higher bleeding risk was observed in pre-pandemic patients (6.5% vs. 5.4%, 95% CI: 1.05-1.60, P=0.014) compared to patients who underwent TAVR during pandemic. During the pandemic, TAVR patients experienced comparable rates of ACM, CV mortality, and stroke to the pre-pandemic period, but with a statistically significant increase in bleeding risk among pre-pandemic patients.