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Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results

Due to shortages of medical resources during the Coronavirus Disease 2019 (COVID-19) pandemic, an allocation algorithm for Transcatheter Aortic Valve Replacement (TAVR) was established. We investigated the impact on patient selection and procedural results. In total, 456 TAVR patients before (pre-CO...

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Autores principales: Berisha, Nora, Klein, Kathrin, Veulemans, Verena, Maier, Oliver, Piayda, Kerstin, Binnebößel, Stephan, Afzal, Shazia, Polzin, Amin, Westenfeld, Ralf, Horn, Patrick, Jung, Christian, Kelm, Malte, Quast, Christine, Zeus, Tobias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224926/
https://www.ncbi.nlm.nih.gov/pubmed/35735818
http://dx.doi.org/10.3390/jcdd9060189
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author Berisha, Nora
Klein, Kathrin
Veulemans, Verena
Maier, Oliver
Piayda, Kerstin
Binnebößel, Stephan
Afzal, Shazia
Polzin, Amin
Westenfeld, Ralf
Horn, Patrick
Jung, Christian
Kelm, Malte
Quast, Christine
Zeus, Tobias
author_facet Berisha, Nora
Klein, Kathrin
Veulemans, Verena
Maier, Oliver
Piayda, Kerstin
Binnebößel, Stephan
Afzal, Shazia
Polzin, Amin
Westenfeld, Ralf
Horn, Patrick
Jung, Christian
Kelm, Malte
Quast, Christine
Zeus, Tobias
author_sort Berisha, Nora
collection PubMed
description Due to shortages of medical resources during the Coronavirus Disease 2019 (COVID-19) pandemic, an allocation algorithm for Transcatheter Aortic Valve Replacement (TAVR) was established. We investigated the impact on patient selection and procedural results. In total, 456 TAVR patients before (pre-COVID-19 group) and 456 TAVR patients after (COVID-19 group) the implementation of our allocation algorithm were compared. Concerning patient characteristics, the COVID-19 group revealed a higher rate of cardiac decompensations/cardiogenic shocks (10.5% vs. 1.3%; p < 0.001), severe angina pectoris (Canadian Cardiovascular Society (CCS) II, III and IV: 18.7% vs. 11.8%; p = 0.004), troponin elevation (>14 ng/L: 84.9% vs. 77%; p = 0.003) and reduced left ventricular ejection fraction (LVEF) (<45%: 18.9% vs. 12%; p = 0.006). Referring to procedural characteristics, more predilatations (46.3% vs. 35.1%; p = 0.001) and a longer procedural time (80.2 min (+/−29.4) vs. 66.9 min (+/−17.5); p < 0.001) were observed. The success rate was evenly high; no differences in safety parameters were reported. Examining the utilization of hospital resources, the COVID-19 group showed a shorter in-hospital stay (8.4 days (+/−5.9) vs. 9.5 days (+/−9.33); p = 0.041) and fewer TAVR patients were treated per month (39 (+/−4.55) vs. 46.11 (+/−7.57); p = 0.03). Our allocation algorithm supported prioritization of sicker patients with similar efficient and safe TAVR procedures. In-hospital stay could be shortened.
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spelling pubmed-92249262022-06-24 Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results Berisha, Nora Klein, Kathrin Veulemans, Verena Maier, Oliver Piayda, Kerstin Binnebößel, Stephan Afzal, Shazia Polzin, Amin Westenfeld, Ralf Horn, Patrick Jung, Christian Kelm, Malte Quast, Christine Zeus, Tobias J Cardiovasc Dev Dis Article Due to shortages of medical resources during the Coronavirus Disease 2019 (COVID-19) pandemic, an allocation algorithm for Transcatheter Aortic Valve Replacement (TAVR) was established. We investigated the impact on patient selection and procedural results. In total, 456 TAVR patients before (pre-COVID-19 group) and 456 TAVR patients after (COVID-19 group) the implementation of our allocation algorithm were compared. Concerning patient characteristics, the COVID-19 group revealed a higher rate of cardiac decompensations/cardiogenic shocks (10.5% vs. 1.3%; p < 0.001), severe angina pectoris (Canadian Cardiovascular Society (CCS) II, III and IV: 18.7% vs. 11.8%; p = 0.004), troponin elevation (>14 ng/L: 84.9% vs. 77%; p = 0.003) and reduced left ventricular ejection fraction (LVEF) (<45%: 18.9% vs. 12%; p = 0.006). Referring to procedural characteristics, more predilatations (46.3% vs. 35.1%; p = 0.001) and a longer procedural time (80.2 min (+/−29.4) vs. 66.9 min (+/−17.5); p < 0.001) were observed. The success rate was evenly high; no differences in safety parameters were reported. Examining the utilization of hospital resources, the COVID-19 group showed a shorter in-hospital stay (8.4 days (+/−5.9) vs. 9.5 days (+/−9.33); p = 0.041) and fewer TAVR patients were treated per month (39 (+/−4.55) vs. 46.11 (+/−7.57); p = 0.03). Our allocation algorithm supported prioritization of sicker patients with similar efficient and safe TAVR procedures. In-hospital stay could be shortened. MDPI 2022-06-10 /pmc/articles/PMC9224926/ /pubmed/35735818 http://dx.doi.org/10.3390/jcdd9060189 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Berisha, Nora
Klein, Kathrin
Veulemans, Verena
Maier, Oliver
Piayda, Kerstin
Binnebößel, Stephan
Afzal, Shazia
Polzin, Amin
Westenfeld, Ralf
Horn, Patrick
Jung, Christian
Kelm, Malte
Quast, Christine
Zeus, Tobias
Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results
title Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results
title_full Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results
title_fullStr Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results
title_full_unstemmed Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results
title_short Structured Allocation of Transcatheter Aortic Valve Replacement Patients during Coronavirus Disease 2019 Pandemic: Impact on Patient Selection and Clinical Results
title_sort structured allocation of transcatheter aortic valve replacement patients during coronavirus disease 2019 pandemic: impact on patient selection and clinical results
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224926/
https://www.ncbi.nlm.nih.gov/pubmed/35735818
http://dx.doi.org/10.3390/jcdd9060189
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