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Cardiology

Characteristics and Outcomes of Patients Deferred for Transcatheter Aortic Valve Replacement Because of COVID-19

Educational Objective
To understand the characteristics and outcomes of patients deferred for transcatheter aortic valve replacement because of COVID-19

1 Credit CME

JAMA Network Open

Published Online: September 30, 2020

Research Letter

Article Information and Disclosures

Richard Ro, MD¹;

Sahil Khera, MD, MPH¹;

Gilbert H. L. Tang, MD, MSc, MBA²;

Parasuram Krishnamoorthy, MD¹;

Samin K. Sharma, MD¹;

Annapoorna Kini, MD¹;

Stamatios Lerakis, MD, PhD¹

Author Affiliations

¹Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, New York
²Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, New York

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Coronavirus disease 2019 (COVID-19) is a global pandemic that has led to diversion of resources to the front lines and postponement of elective procedures. Patients with structural heart disease are a high-risk cohort because of their age and comorbidities. Management of their underlying condition has sometimes been delayed as a result of efforts to avoid community and health care setting exposure to COVID-19. An executive order was enacted by the New York State government on March 22, 2020, leading to cancellation of elective procedures. We describe here the outcomes of patients with symptomatic, severe aortic stenosis (AS) from our structural heart disease program during the COVID-19 pandemic.

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Article Information

Accepted for Publication: July 27, 2020.

Published: September 30, 2020. doi:10.1001/jamanetworkopen.2020.19801

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Ro R et al. JAMA Network Open.

Corresponding Author: Stamatios Lerakis, MD, PhD, Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029 (stamatios.lerakis@mountsinai.org).

Author Contributions: Drs Ro and Lerakis had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Khera, Kini, Lerakis.

Acquisition, analysis, or interpretation of data: Ro, Khera, Tang, Krishnamoorthy, Sharma, Lerakis.

Drafting of the manuscript: Ro, Krishnamoorthy, Lerakis.

Critical revision of the manuscript for important intellectual content: Khera, Tang, Sharma, Kini.

Statistical analysis: Krishnamoorthy, Lerakis.

Administrative, technical, or material support: Khera, Tang, Sharma.

Supervision: Khera, Tang, Kini, Lerakis.

Conflict of Interest Disclosures: Dr Khera reported being a consultant for Abbott, Medtronic, and Boston Scientific, and receiving speakers’ honoraria from Medtronic. Dr Tang reported being a physician proctor for Medtronic and a consultant for Medtronic, Abbott Structural Heart, and W. L. Gore & Associates. No other disclosures were reported.

Additional Contributions: Malcolm Anastasius, MBBS, PhD (Mount Sinai Hospital), provided assistance with data analysis; he was not compensated for this work.

References

Shah PB , Welt FGP , Mahmud E , et al. Triage considerations for patients referred for structural heart disease intervention during the COVID-19 pandemic: an ACC /SCAI position statement. JACC Cardiovasc Interv. 2020;13(12):1484-1488. doi:10.1016/j.jcin.2020.04.001 PubMed Google Scholar Crossref

Chung CJ , Nazif TM , Wolbinski M , et al. The restructuring of structural heart disease during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(23):2974-2983. doi:10.1016/j.jacc.2020.04.009 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.