Subject(s)
Aortic Valve Stenosis/surgery , Hospitalization/statistics & numerical data , Stroke/epidemiology , Time-to-Treatment/statistics & numerical data , Transcatheter Aortic Valve Replacement , Aged , Aged, 80 and over , Aortic Valve Stenosis/mortality , COVID-19 , Case-Control Studies , Coronavirus Infections , Female , Humans , Kaplan-Meier Estimate , Male , Pandemics , Pneumonia, Viral , Referral and Consultation , Severity of Illness IndexSubject(s)
Aortic Valve Stenosis/physiopathology , Coronavirus Infections , Pandemics , Pneumonia, Viral , Time-to-Treatment , Transcatheter Aortic Valve Replacement , Aged , Aged, 80 and over , Angina, Unstable/epidemiology , Aortic Valve Stenosis/mortality , Aortic Valve Stenosis/surgery , Betacoronavirus , COVID-19 , Case-Control Studies , Coronary Artery Disease/epidemiology , Disease Progression , Female , Heart Failure/epidemiology , Humans , Male , SARS-CoV-2 , Severity of Illness Index , Stroke/epidemiology , Stroke Volume , Syncope/epidemiologySubject(s)
Aortic Valve Stenosis/surgery , Betacoronavirus/pathogenicity , Coronavirus Infections , Heart Valve Prosthesis Implantation , Pandemics , Pneumonia, Viral , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/mortality , COVID-19 , Clinical Decision-Making , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/transmission , Coronavirus Infections/virology , Health Status , Heart Valve Prosthesis Implantation/adverse effects , Heart Valve Prosthesis Implantation/mortality , Host-Pathogen Interactions , Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Risk Assessment , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Time Factors , Time-to-Treatment , Transcatheter Aortic Valve ReplacementSubject(s)
Aortic Valve Stenosis/epidemiology , Betacoronavirus , Coronavirus Infections/complications , Pneumonia, Viral/complications , Transcatheter Aortic Valve Replacement/statistics & numerical data , Aged, 80 and over , Aortic Valve Stenosis/complications , Aortic Valve Stenosis/mortality , Aortic Valve Stenosis/surgery , COVID-19 , Female , Humans , Italy/epidemiology , Male , Pandemics , Registries , SARS-CoV-2 , Survival Analysis , Treatment OutcomeABSTRACT
The novel coronavirus disease-2019 (COVID-19) pandemic has created uncertainty in the management of patients with severe aortic stenosis. This population experiences high mortality from delays in treatment of valve disease but is largely overlapping with the population of highest mortality from COVID-19. The authors present strategies for managing patients with severe aortic stenosis in the COVID-19 era. The authors suggest transitions to virtual assessments and consultation, careful pruning and planning of necessary testing, and fewer and shorter hospital admissions. These strategies center on minimizing patient exposure to COVID-19 and expenditure of human and health care resources without significant sacrifice to patient outcomes during this public health emergency. Areas of innovation to improve care during this time include increased use of wearable and remote devices to assess patient performance and vital signs, devices for facile cardiac assessment, and widespread use of clinical protocols for expedient discharge with virtual physical therapy and cardiac rehabilitation options.