Management and screening criteria for TAVR surgery in patients with Aortic Stenosis during the COVID-19 pandemic

Authors

DOI:

https://doi.org/10.33448/rsd-v11i14.36268

Keywords:

Aortic stenosis; Pandemic COVID-19; Transcatheter aortic valve replacement.

Abstract

The health system overload on a global scale was one of the consequences, where elective criteria for urgent and emergency surgeries were adapted to a new reality. In the case of aortic stenosis surgery (AS), the transcatheter aortic valve replacement (TAVR) technique was prioritized over conventional surgery (AVR) for being less invasive and indicated for patients at risk. To assess the feasibility of the study, we conducted a previous search where individual searches were made in PubMed, Scielo, and Web of Science, using Mesh/Decs descriptors and Boolean operators, where 129 articles were found and 10 were selected. We found that the screening of TAVR occurred mainly by analyzing the severity of symptoms of AS, reduced left ventricular ejection fraction, history of stroke, obstructive coronary disease, associated with the risk of infection.  Surgical intervention through TAVR was shown to be safe in patients with high cardiovascular risk, regardless of the risk of sars-cov-2 infection. We conclude that TAVR is recommended in a pandemic scenario, mainly for reducing thromboembolic complications and even with risk of contamination, surgery should be performed to avoid possible deaths.

References

Aajal, A., El Boussaadani, B., Hara, L., Benajiba, C., Boukouk, O., Benali, M., Ouadfel, O., Bendoudouch, H., Zergoune, N., Alkattan, D., Mahdi, Z., Najdi, A., & Raissuni, Z. (2021). Les conséquences du confinement sur les maladies cardiovasculaires. Annales de cardiologie et d’angeiologie, 70(2), 94–101. https://doi.org/10.1016/j.ancard.2021.01.006

Ahamed, J. (2020). Severe aortic stenosis patient risk during the COVID-19 pandemic. Open Heart, 7(2), e001355. https://doi.org/10.1136/openhrt-2020-001355

Annie, F. H., Alkhaimy, H., Nanjundappa, A., & Elashery, A. (2022). Association between myocarditis and mortality in COVID-19 patients in a large registry. Mayo Clinic Proceedings. Innovations, Quality & Outcomes, 6(2), 114–119. https://doi.org/10.1016/j.mayocpiqo.2021.12.006

Basman, C., Kliger, C. A., Pirelli, L., & Scheinerman, S. J. (2020). Management of elective aortic valve replacement over the long term in the era of COVID-19. European Journal of Cardio-Thoracic Surgery: Official Journal of the European Association for Cardio-Thoracic Surgery, 57(6), 1029–1031. https://doi.org/10.1093/ejcts/ezaa152

da Costa Santos, C. M., de Mattos Pimenta, C. A., & Nobre, M. R. C. (2007). The PICO strategy for the research question construction and evidence

search. Revista Latino-Americana de Enfermagem, 15(3), 508–511. https://doi.org/10.1590/s0104-11692007000300023

Diretrizes metodológicas : elaboração de revisão sistemática e meta-análise de ensaios clínicos randomizados / Ministério da Saúde, Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde, Departamento de Gestão e Incorporação de Tecnologias em Saúde. – Brasília : Ministério da Saúde, 2021. 93 p. : il. https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_elaboracao_revisao_sistematica_meta-analise.pdf

Fontes-Carvalho, R., Guerreiro, C., Oliveira, E. I., & Braga, P. (2020). Present and future economic impact of transcatheter aortic valve replacement on the Portuguese national healthcare system. Revista Portuguesa de Cardiologia (English Edition), 39(9), 479–488. https://doi.org/10.1016/j.repc.2020.02.013

García-Lledó, A., Del Palacio-Salgado, M., Álvarez-Sanz, C., Pérez-Gil, M. M., & Cruz-Díaz, Á. (2022). Tromboembolismo pulmonar durante la pandemia por SARS-CoV-2: características clínicas y radiológicas. Revista clinica espanola, 222(6), 354–358. https://doi.org/10.1016/j.rce.2021.01.001

Gomes, A. I. M., Vidigal, A. S., Leite, L. D. G., Alves, G. C., Souza, T. F., & Santos, N. B. D. (2020). Covid-19 e o seu efeito pró-trombótico: Uso DE tromboprofilaxia no tratamento. Hematology, Transfusion and Cell Therapy, 42, 523. https://doi.org/10.1016/j.htct.2020.10.883

Joseph, J., Kotronias, R. A., Estrin-Serlui, T., Cahill, T. J., Kharbanda, R. K., Newton, J. D., Grebenik, C., Dawkins, S., & Banning, A. P. (2021). Safety and operational efficiency of restructuring and redeploying a transcatheter aortic valve replacement service during the COVID-19 pandemic: The oxford experience. Cardiovascular Revascularization Medicine: Including Molecular Interventions, 31, 26–31. https://doi.org/10.1016/j.carrev.2020.12.002

Mach, M., Okutucu, S., Kerbel, T., Arjomand, A., Fatihoglu, S. G., Werner, P., Simon, P., & Andreas, M. (2021). Vascular complications in TAVR: Incidence, clinical impact, and management. Journal of Clinical Medicine, 10(21), 5046. https://doi.org/10.3390/jcm10215046

Maeda, T., Obata, R., Rizk, D., & Kuno, T. (2021). Cardiac injury and outcomes of patients with COVID-19 in New York city. Heart, Lung & Circulation, 30(6), 848–853. https://doi.org/10.1016/j.hlc.2020.10.025

Martin, G. P., Curzen, N., Goodwin, A. T., Nolan, J., Balacumaraswami, L., Ludman, P. F., Kontopantelis, E., Wu, J., Gale, C. P., de Belder, M. A., & Mamas, M. A. (2021). Indirect impact of the COVID-19 pandemic on activity and outcomes of transcatheter and surgical treatment of aortic stenosis in England. Circulation. Cardiovascular Interventions, 14(5), e010413. https://doi.org/10.1161/CIRCINTERVENTIONS.120.010413

Mendes, F. F. (2020). COVID‐19 e a retomada das cirurgias eletivas. Como voltaremos à normalidade? Brazilian journal of anesthesiology (Elsevier), 70(5), 455–456. https://doi.org/10.1016/j.bjan.2020.09.001

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine, 151(4), 264–269, W64. https://doi.org/10.7326/0003-4819-151-4-200908180-00135Park, B. E., Lee, J. H., Park, H. K., Kim, H. N., Jang, S. Y., Bae, M. H., Yang, D. H., Park, H. S., Cho, Y., Lee, B. Y., Nam, C. W., Lee, J. B., Kim, U., Chae, S. C., & Daegu COVID-19 Research Project. (2021). Impact of cardiovascular risk factors and cardiovascular diseases on outcomes in patients hospitalized with COVID-19 in Daegu Metropolitan City. Journal of Korean Medical Science, 36(2), e15. https://doi.org/10.3346/jkms.2021.36.e15

Passos, H. D., Alves, M. C., Baumworcel, L., Vieira, J. P. C., Garcez, J. D. S., & Sousa, A. C. S. (2020). Infecção pelo SARS-Cov-2 e Tromboembolismo Pulmonar – Comportamento Pró - Trombótico da COVID-19. Arquivos Brasileiros de Cardiologia, 115(1), 142–145. https://doi.org/10.36660/abc.20200427

Perdoncin, E., Greenbaum, A. B., Grubb, K. J., Babaliaros, V. C., Keegan, P., Ceretto-Clark, B., Wei, J., Guyton, R. A., Paone, G., Byku, I., Gleason, P. T., Biven, K., Mathew, P., Mortorano, C., Inci, E. K., Faaborg-Andersen, C., Mitchell, R., & Devireddy, C. M. (2021). Safety of same-day discharge after uncomplicated, minimalist transcatheter aortic valve replacement in the COVID-19 era. Catheterization and Cardiovascular Interventions: Official Journal of the Society for Cardiac Angiography & Interventions, 97(5), 940–947. https://doi.org/10.1002/ccd.29453

Ro, R., Khera, S., Tang, G. H. L., Krishnamoorthy, P., Sharma, S. K., Kini, A., & Lerakis, S. (2020). Characteristics and outcomes of patients deferred for transcatheter aortic valve replacement because of COVID-19. JAMA Network Open, 3(9), e2019801. https://doi.org/10.1001/jamanetworkopen.2020.19801

Rother, E. T. (2007). Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, 20(2), v–vi. https://doi.org/10.1590/s0103-21002007000200001

Ryffel, C., Lanz, J., Corpataux, N., Reusser, N., Stortecky, S., Windecker, S., & Pilgrim, T. (2020). Mortality, stroke, and hospitalization associated with deferred vs expedited aortic valve replacement in patients referred for symptomatic severe aortic stenosis during the COVID-19 pandemic. JAMA Network Open, 3(9), e2020402. https://doi.org/10.1001/jamanetworkopen.2020.20402

Shah, P. B., Welt, F. G. P., Mahmud, E., Phillips, A., Kleiman, N. S., Young, M. N., Sherwood, M., Batchelor, W., Wang, D. D., Davidson, L., Wyman, J., Kadavath, S., Szerlip, M., Hermiller, J., Fullerton, D., & Anwaruddin, S. (2020). Triage considerations for patients referred for structural heart disease intervention during the COVID-19 pandemic: An ACC/SCAI position statement. Catheterization and Cardiovascular Interventions: Official Journal of the Society for Cardiac Angiography & Interventions, 96(3), 659–663. https://doi.org/10.1002/ccd.28910

Valdebenito, M., Massalha, E., Barbash, I. M., Maor, E., Fefer, P., Guetta, V., & Segev, A. (2021). Transcatheter aortic valve implantation during the COVID-19 pandemic. The American Journal of Cardiology, 145, 97–101. https://doi.org/10.1016/j.amjcard.2020.12.086

Veulemans, V., Afzal, S., Papadopoulos, G., Maier, O., Kelm, M., Zeus, T., & Hellhammer, K. (2020). TAVR-related echocardiographic assessment - status quo, challenges and perspectives. Acta Cardiologica, 75(4), 275–285. https://doi.org/10.1080/00015385.2019.1579979

Published

27/10/2022

How to Cite

MAIA, L. S.; FERNANDES, C. R. Management and screening criteria for TAVR surgery in patients with Aortic Stenosis during the COVID-19 pandemic. Research, Society and Development, [S. l.], v. 11, n. 14, p. e302111436268, 2022. DOI: 10.33448/rsd-v11i14.36268. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/36268. Acesso em: 22 nov. 2024.

Issue

Section

Health Sciences