tetano
Editor, Senior Moderator
JACC Cardiovasc Interv
. 2023 Dec 20:S1936-8798(23)01436-X.
doi: 10.1016/j.jcin.2023.10.041. Online ahead of print. Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study
Xavier Armario[SUP] 1 [/SUP], Jennifer Carron[SUP] 2 [/SUP], Andrew J Simpkin[SUP] 3 [/SUP], Mohamed Elhadi[SUP] 2 [/SUP], Ciara Kennedy[SUP] 2 [/SUP], Mohamed Abdel-Wahab[SUP] 4 [/SUP], Sabine Bleiziffer[SUP] 5 [/SUP], Thierry Lefèvre[SUP] 6 [/SUP], Alexander Wolf[SUP] 7 [/SUP], Thomas Pilgrim[SUP] 8 [/SUP], Pedro A Villablanca[SUP] 9 [/SUP], Daniel J Blackman[SUP] 10 [/SUP], Nicolas M Van Mieghem[SUP] 11 [/SUP], Christian Hengstenberg[SUP] 12 [/SUP], Martin J Swaans[SUP] 13 [/SUP], Bernard D Prendergast[SUP] 14 [/SUP], Tiffany Patterson[SUP] 14 [/SUP], Marco Barbanti[SUP] 15 [/SUP], John G Webb[SUP] 16 [/SUP], Miles Behan[SUP] 17 [/SUP], Jon Resar[SUP] 18 [/SUP], Mao Chen[SUP] 19 [/SUP], David Hildick-Smith[SUP] 20 [/SUP], Mark S Spence[SUP] 21 [/SUP], David Zweiker[SUP] 22 [/SUP], Rodrigo Bagur[SUP] 23 [/SUP], Rui Teles[SUP] 24 [/SUP], Flavio L Ribichini[SUP] 25 [/SUP], Dariusz Jagielak[SUP] 26 [/SUP], Duk-Woo Park[SUP] 27 [/SUP], Ran Kornowski[SUP] 28 [/SUP], Joanna J Wykrzykowska[SUP] 29 [/SUP], Matjaz Bunc[SUP] 30 [/SUP], Rodrigo Estévez-Loureiro[SUP] 31 [/SUP], Karl Poon[SUP] 32 [/SUP], Matthias Götberg[SUP] 33 [/SUP], Raban V Jeger[SUP] 34 [/SUP], Hüseyin Ince[SUP] 35 [/SUP], Erik J S Packer[SUP] 36 [/SUP], Marco Angelillis[SUP] 37 [/SUP], Luis Nombela-Franco[SUP] 38 [/SUP], Yingqiang Guo[SUP] 19 [/SUP], Mikko Savontaus[SUP] 39 [/SUP], Abdulrahman M Al-Moghairi[SUP] 40 [/SUP], Catalina Andreea Parasca[SUP] 41 [/SUP], Chad Kliger[SUP] 42 [/SUP], David Roy[SUP] 43 [/SUP], Levente Molnár[SUP] 44 [/SUP], Mariana Silva[SUP] 45 [/SUP], Jonathon White[SUP] 46 [/SUP], Masanori Yamamoto[SUP] 47 [/SUP], Pedro Carrilho-Ferreira[SUP] 48 [/SUP], Stefan Toggweiler[SUP] 49 [/SUP], Vassileios Voudris[SUP] 50 [/SUP], Yohei Ohno[SUP] 51 [/SUP], Inês Rodrigues[SUP] 52 [/SUP], Radosław Parma[SUP] 53 [/SUP], Soledad Ojeda[SUP] 54 [/SUP], Kostas Toutouzas[SUP] 55 [/SUP], Ander Regueiro[SUP] 56 [/SUP], Marek Grygier[SUP] 57 [/SUP], Khaled AlMerri[SUP] 58 [/SUP], Ignacio Cruz-González[SUP] 59 [/SUP], Viliam Fridrich[SUP] 60 [/SUP], José M de la Torre Hernández[SUP] 61 [/SUP], Stephane Noble[SUP] 62 [/SUP], Petr Kala[SUP] 63 [/SUP], Lluis Asmarats[SUP] 64 [/SUP], Ibrahim Halil Kurt[SUP] 65 [/SUP], Johan Bosmans[SUP] 66 [/SUP], Martins Erglis[SUP] 67 [/SUP], Ivan Casserly[SUP] 68 [/SUP], Dounia Iskandarani[SUP] 69 [/SUP], Ravinay Bhindi[SUP] 70 [/SUP], Joelle Kefer[SUP] 71 [/SUP], Wei-Hsian Yin[SUP] 72 [/SUP], Liesbeth Rosseel[SUP] 73 [/SUP], Hyo-Soo Kim[SUP] 74 [/SUP], Stephen O'Connor[SUP] 75 [/SUP], Farrel Hellig[SUP] 76 [/SUP], Matias Sztejfman[SUP] 77 [/SUP], Oscar Mendiz[SUP] 78 [/SUP], Andres M Pineda[SUP] 79 [/SUP], Ashok Seth[SUP] 80 [/SUP], Elton Pllaha[SUP] 81 [/SUP], Fabio S de Brito Jr[SUP] 82 [/SUP], Vilhelmas Bajoras[SUP] 83 [/SUP], Mohammed A Balghith[SUP] 84 [/SUP], Michael Lee[SUP] 85 [/SUP], Guering Eid-Lidt[SUP] 86 [/SUP], Bert Vandeloo[SUP] 87 [/SUP], Vinicius Daher Vaz[SUP] 88 [/SUP], Mirvat Alasnag[SUP] 89 [/SUP], Gian Paolo Ussia[SUP] 90 [/SUP], Edgar Tay[SUP] 91 [/SUP], Jorge Mayol[SUP] 92 [/SUP], Sengottuvelu Gunasekaran[SUP] 93 [/SUP], Gennaro Sardella[SUP] 94 [/SUP], Wacin Buddhari[SUP] 95 [/SUP], Hsien-Li Kao[SUP] 96 [/SUP], Antonio Dager[SUP] 97 [/SUP], Apostolos Tzikas[SUP] 98 [/SUP], Ingibjörg J Gudmundsdottir[SUP] 99 [/SUP], Ahmad Edris[SUP] 100 [/SUP], Luis Abel Gutiérrez Jaikel[SUP] 101 [/SUP], Eduardo A Arias[SUP] 102 [/SUP], Mohammed Al-Hijji[SUP] 103 [/SUP], Mehmet Ertürk[SUP] 104 [/SUP], César Conde-Vela[SUP] 105 [/SUP], Darko Boljević[SUP] 106 [/SUP], Adolfo Ferrero Guadagnoli[SUP] 107 [/SUP], Toomas Hermlin[SUP] 108 [/SUP], Ahmed M ElGuindy[SUP] 109 [/SUP], Moysés de Oliveira Lima-Filho[SUP] 110 [/SUP], Luciano de Moura Santos[SUP] 111 [/SUP], Luis Perez[SUP] 112 [/SUP], Gabriel Maluenda[SUP] 113 [/SUP], Ali Rıza Akyüz[SUP] 114 [/SUP], Imad A Alhaddad[SUP] 115 [/SUP], Haitham Amin[SUP] 116 [/SUP], Chak-Yu So[SUP] 117 [/SUP], Arif A Al Nooryani[SUP] 118 [/SUP], Carlos Vaca[SUP] 119 [/SUP], Juan Albistur[SUP] 120 [/SUP], Quang Ngoc Nguyen[SUP] 121 [/SUP], Dabit Arzamendi[SUP] 64 [/SUP], Eberhard Grube[SUP] 122 [/SUP], Thomas Modine[SUP] 123 [/SUP], Didier Tchétché[SUP] 124 [/SUP], Kentaro Hayashida[SUP] 125 [/SUP], Azeem Latib[SUP] 126 [/SUP], Raj R Makkar[SUP] 127 [/SUP], Nicolo Piazza[SUP] 128 [/SUP], Lars Søndergaard[SUP] 129 [/SUP], John William McEvoy[SUP] 130 [/SUP], Darren Mylotte[SUP] 131 [/SUP]
Affiliations
Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays.
Objectives: The study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity.
Methods: This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses.
Results: We included 130 centers from 61 countries, including 65,980 TAVR procedures. The first and second pandemic waves were associated with a significant reduction of 15% (P < 0.001) and 7% (P < 0.001) in monthly TAVR case volume, respectively, compared with the prepandemic period. The third pandemic wave was not associated with reduced TAVR activity. A greater reduction in TAVR activity was observed in Africa (-52%; P = 0.001), Central-South America (-33%; P < 0.001), and Asia (-29%; P < 0.001). Private hospitals (P = 0.005), urban areas (P = 0.011), low-volume centers (P = 0.002), countries with lower development (P < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity.
Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.
Keywords: aortic valve stenosis; coronavirus disease 2019; transcatheter aortic valve replacement; valvular heart disease.
. 2023 Dec 20:S1936-8798(23)01436-X.
doi: 10.1016/j.jcin.2023.10.041. Online ahead of print. Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study
Xavier Armario[SUP] 1 [/SUP], Jennifer Carron[SUP] 2 [/SUP], Andrew J Simpkin[SUP] 3 [/SUP], Mohamed Elhadi[SUP] 2 [/SUP], Ciara Kennedy[SUP] 2 [/SUP], Mohamed Abdel-Wahab[SUP] 4 [/SUP], Sabine Bleiziffer[SUP] 5 [/SUP], Thierry Lefèvre[SUP] 6 [/SUP], Alexander Wolf[SUP] 7 [/SUP], Thomas Pilgrim[SUP] 8 [/SUP], Pedro A Villablanca[SUP] 9 [/SUP], Daniel J Blackman[SUP] 10 [/SUP], Nicolas M Van Mieghem[SUP] 11 [/SUP], Christian Hengstenberg[SUP] 12 [/SUP], Martin J Swaans[SUP] 13 [/SUP], Bernard D Prendergast[SUP] 14 [/SUP], Tiffany Patterson[SUP] 14 [/SUP], Marco Barbanti[SUP] 15 [/SUP], John G Webb[SUP] 16 [/SUP], Miles Behan[SUP] 17 [/SUP], Jon Resar[SUP] 18 [/SUP], Mao Chen[SUP] 19 [/SUP], David Hildick-Smith[SUP] 20 [/SUP], Mark S Spence[SUP] 21 [/SUP], David Zweiker[SUP] 22 [/SUP], Rodrigo Bagur[SUP] 23 [/SUP], Rui Teles[SUP] 24 [/SUP], Flavio L Ribichini[SUP] 25 [/SUP], Dariusz Jagielak[SUP] 26 [/SUP], Duk-Woo Park[SUP] 27 [/SUP], Ran Kornowski[SUP] 28 [/SUP], Joanna J Wykrzykowska[SUP] 29 [/SUP], Matjaz Bunc[SUP] 30 [/SUP], Rodrigo Estévez-Loureiro[SUP] 31 [/SUP], Karl Poon[SUP] 32 [/SUP], Matthias Götberg[SUP] 33 [/SUP], Raban V Jeger[SUP] 34 [/SUP], Hüseyin Ince[SUP] 35 [/SUP], Erik J S Packer[SUP] 36 [/SUP], Marco Angelillis[SUP] 37 [/SUP], Luis Nombela-Franco[SUP] 38 [/SUP], Yingqiang Guo[SUP] 19 [/SUP], Mikko Savontaus[SUP] 39 [/SUP], Abdulrahman M Al-Moghairi[SUP] 40 [/SUP], Catalina Andreea Parasca[SUP] 41 [/SUP], Chad Kliger[SUP] 42 [/SUP], David Roy[SUP] 43 [/SUP], Levente Molnár[SUP] 44 [/SUP], Mariana Silva[SUP] 45 [/SUP], Jonathon White[SUP] 46 [/SUP], Masanori Yamamoto[SUP] 47 [/SUP], Pedro Carrilho-Ferreira[SUP] 48 [/SUP], Stefan Toggweiler[SUP] 49 [/SUP], Vassileios Voudris[SUP] 50 [/SUP], Yohei Ohno[SUP] 51 [/SUP], Inês Rodrigues[SUP] 52 [/SUP], Radosław Parma[SUP] 53 [/SUP], Soledad Ojeda[SUP] 54 [/SUP], Kostas Toutouzas[SUP] 55 [/SUP], Ander Regueiro[SUP] 56 [/SUP], Marek Grygier[SUP] 57 [/SUP], Khaled AlMerri[SUP] 58 [/SUP], Ignacio Cruz-González[SUP] 59 [/SUP], Viliam Fridrich[SUP] 60 [/SUP], José M de la Torre Hernández[SUP] 61 [/SUP], Stephane Noble[SUP] 62 [/SUP], Petr Kala[SUP] 63 [/SUP], Lluis Asmarats[SUP] 64 [/SUP], Ibrahim Halil Kurt[SUP] 65 [/SUP], Johan Bosmans[SUP] 66 [/SUP], Martins Erglis[SUP] 67 [/SUP], Ivan Casserly[SUP] 68 [/SUP], Dounia Iskandarani[SUP] 69 [/SUP], Ravinay Bhindi[SUP] 70 [/SUP], Joelle Kefer[SUP] 71 [/SUP], Wei-Hsian Yin[SUP] 72 [/SUP], Liesbeth Rosseel[SUP] 73 [/SUP], Hyo-Soo Kim[SUP] 74 [/SUP], Stephen O'Connor[SUP] 75 [/SUP], Farrel Hellig[SUP] 76 [/SUP], Matias Sztejfman[SUP] 77 [/SUP], Oscar Mendiz[SUP] 78 [/SUP], Andres M Pineda[SUP] 79 [/SUP], Ashok Seth[SUP] 80 [/SUP], Elton Pllaha[SUP] 81 [/SUP], Fabio S de Brito Jr[SUP] 82 [/SUP], Vilhelmas Bajoras[SUP] 83 [/SUP], Mohammed A Balghith[SUP] 84 [/SUP], Michael Lee[SUP] 85 [/SUP], Guering Eid-Lidt[SUP] 86 [/SUP], Bert Vandeloo[SUP] 87 [/SUP], Vinicius Daher Vaz[SUP] 88 [/SUP], Mirvat Alasnag[SUP] 89 [/SUP], Gian Paolo Ussia[SUP] 90 [/SUP], Edgar Tay[SUP] 91 [/SUP], Jorge Mayol[SUP] 92 [/SUP], Sengottuvelu Gunasekaran[SUP] 93 [/SUP], Gennaro Sardella[SUP] 94 [/SUP], Wacin Buddhari[SUP] 95 [/SUP], Hsien-Li Kao[SUP] 96 [/SUP], Antonio Dager[SUP] 97 [/SUP], Apostolos Tzikas[SUP] 98 [/SUP], Ingibjörg J Gudmundsdottir[SUP] 99 [/SUP], Ahmad Edris[SUP] 100 [/SUP], Luis Abel Gutiérrez Jaikel[SUP] 101 [/SUP], Eduardo A Arias[SUP] 102 [/SUP], Mohammed Al-Hijji[SUP] 103 [/SUP], Mehmet Ertürk[SUP] 104 [/SUP], César Conde-Vela[SUP] 105 [/SUP], Darko Boljević[SUP] 106 [/SUP], Adolfo Ferrero Guadagnoli[SUP] 107 [/SUP], Toomas Hermlin[SUP] 108 [/SUP], Ahmed M ElGuindy[SUP] 109 [/SUP], Moysés de Oliveira Lima-Filho[SUP] 110 [/SUP], Luciano de Moura Santos[SUP] 111 [/SUP], Luis Perez[SUP] 112 [/SUP], Gabriel Maluenda[SUP] 113 [/SUP], Ali Rıza Akyüz[SUP] 114 [/SUP], Imad A Alhaddad[SUP] 115 [/SUP], Haitham Amin[SUP] 116 [/SUP], Chak-Yu So[SUP] 117 [/SUP], Arif A Al Nooryani[SUP] 118 [/SUP], Carlos Vaca[SUP] 119 [/SUP], Juan Albistur[SUP] 120 [/SUP], Quang Ngoc Nguyen[SUP] 121 [/SUP], Dabit Arzamendi[SUP] 64 [/SUP], Eberhard Grube[SUP] 122 [/SUP], Thomas Modine[SUP] 123 [/SUP], Didier Tchétché[SUP] 124 [/SUP], Kentaro Hayashida[SUP] 125 [/SUP], Azeem Latib[SUP] 126 [/SUP], Raj R Makkar[SUP] 127 [/SUP], Nicolo Piazza[SUP] 128 [/SUP], Lars Søndergaard[SUP] 129 [/SUP], John William McEvoy[SUP] 130 [/SUP], Darren Mylotte[SUP] 131 [/SUP]
Affiliations
- PMID: 38180419
- DOI: 10.1016/j.jcin.2023.10.041
Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays.
Objectives: The study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity.
Methods: This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses.
Results: We included 130 centers from 61 countries, including 65,980 TAVR procedures. The first and second pandemic waves were associated with a significant reduction of 15% (P < 0.001) and 7% (P < 0.001) in monthly TAVR case volume, respectively, compared with the prepandemic period. The third pandemic wave was not associated with reduced TAVR activity. A greater reduction in TAVR activity was observed in Africa (-52%; P = 0.001), Central-South America (-33%; P < 0.001), and Asia (-29%; P < 0.001). Private hospitals (P = 0.005), urban areas (P = 0.011), low-volume centers (P = 0.002), countries with lower development (P < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity.
Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.
Keywords: aortic valve stenosis; coronavirus disease 2019; transcatheter aortic valve replacement; valvular heart disease.