Interventional cardiology in Serbia during COVID-19 pandemic for the period of 2019-2022

Background: The aim of this study was to analyze the trends in catheterization laboratory procedures during COVID-19 pandemic for the 2019-2022 period. Methods: Presentation of results in the interventional treatment of coronary artery disease and, to a lesser extent, structural heart diseases procedures in Cath Labs in Serbia in the 2019-2021 period. Results: In 2019, in the territory of the Republic of Serbia, interventional cardiology practice was carried out in 17 centers (of which 10 tertiary and 7 secondary level health care centers within general hospitals) with a total of 28 cardiac catheterization labs. Meanwhile, general hospital Novi Pazar and Cuprija cath lab also started to work, so that there are currently 19 state owned centers in the territory of the Republic of Serbia where interventional cardiology procedures are carried out. In 2019, a total of 47,522 procedures were performed in all Cath Labs, of which: 30,884 coronary angiographies, 16,658 PCI procedures, 1,601 emergency (without STEMI) procedures, 5,345 primary PCI procedures with 24,879 stents implanted, as well as 26 TAVR procedures and 68 percutaneous ASD closure procedures. A total of 96 specialist doctors worked in these labs, along with 38 fellows in training. During 2020, there were a total of 31,052 procedures in all Cath Labs, of which: 19,260 coronary angiographies, 11,792 PCI procedures, 1,299 emergency PCI (without STEMI), 4,807 primary PCI procedures, and 17,499 stents implanted, plus 10 TAVR procedures and 54 percutaneous ASD closures. 109 specialist doctors and 28 fellows in training worked in all labs. In 2021, a total of 37,042 procedures were performed in all labs, including: 24,055 coronary angiographies, 12,987 PCI procedures, 2,248 emergency (without STEMI) PCI procedures, and 5,006 primary PCIs, plus 23 TAVR procedures and 59 percutaneous ASD closures. 110 specialist doctors and 28 fellows in training worked in all labs. In the first 9 months of 2022, a total of 155 TAVR procedures were performed, of which 122 were performed at the ICVD "Dedinje", 17 at the ICVD "Vojvodina" and 16 at the University Clinical Center of Serbia. Conclusion: The work results in the field of interventional cardiology in Serbia are comparable to European countries, in many segments even with the most economically developed among them. A significant drop in the number of procedures performed in 2020 at the expense of elective procedures is noted, as an unequivocal impact of the COVID19 pandemic and an increase after that with a tendency to return to the pre-pandemic level.