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Transcatheter aortic valve implantation versus surgical aortic valve replacement during the COVID‐19 pandemic—Current practice and concerns
Author(s) -
Shafi Ahmed M. A.,
Awad Wael I.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15182
Subject(s) - medicine , covid-19 , pandemic , aortic valve replacement , cardiology , aortic valve , intensive care medicine , disease , valve replacement , cardiac surgery , surgery , stenosis , infectious disease (medical specialty)
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.