Key result
Transcatheter aortic valve implantation is increasingly considered over surgical replacement for younger and low-risk patients during the COVID-19 pandemic, despite unknown long-term outcomes.
Why the study?
COVID-19 reduced cardiac surgery provision and expanded TAVI use to younger, lower-risk patients, raising concerns due to unknown long-term outcomes in previously excluded populations.
Does TAVI provide advantages over SAVR for patients with aortic valve disease during the COVID-19 pandemic?
Does TAVI provide advantages over SAVR for patients with aortic valve disease during the COVID-19 pandemic?
The COVID-19 pandemic has accelerated the use of TAVI in younger and lower-risk patients to preserve healthcare resources, though long-term outcomes in these populations remain uncertain.
TAVR programs remain feasible amid resource limits but post-procedure COVID mortality raises caution; leaves open optimal timing and infection protocols.
COVID-19 has had a dramatic impact on the provision of healthcare. COVID-19 can manifest with cardiac and thrombotic presentations. Additionally, patients with cardiovascular comorbidities are at an increased risk of adverse outcomes related to COVID-19 infection. This in turn has led to a significant reduction in the provision of cardiac surgery with alternative management options utilized to address patients with significant disease. In terms of aortic valve disease, transcatheter aortic valve implantation (TAVI) provides advantages over surgical aortic valve replacement in with a lower burden on healthcare resources. COVID-19 also resulted in changes in management strategies and as such TAVI is now being considered in younger- and low-risk patients. However, long term data with regard to TAVI is still unknown, and the use in patient groups that have been excluded in the large pivotal studies that established TAVI as an alternative to surgery has raised specific concerns in the use of TAVI as the preferred treatment choice. With the long term ramification unknown, it is essential that decisions are made with caution.
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Shafì et al. (2020) conducted a review in Aortic valve disease. Transcatheter aortic valve implantation (TAVI) vs. Surgical aortic valve replacement was evaluated. Transcatheter aortic valve implantation is increasingly considered over surgical replacement for younger and low-risk patients during the COVID-19 pandemic, despite unknown long-term outcomes.
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