Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;96(5):1080-1086.
doi: 10.1002/ccd.29262. Epub 2020 Sep 12.

Cardiac procedural deferral during the coronavirus (COVID-19) pandemic

Celina M Yong  1   2 , Lawrence Ang  3 , Frederick G P Welt  4   5 , Santosh Gummidipundi  1 , Timothy D Henry  4   6   7 , Duane S Pinto  8 , David Cox  7   9 , Paul Wang  2 , Steven Asch  1   10 , Ehtisham Mahmud  3   7 , William F Fearon  1   2 ; Society for Cardiovascular Angiography and Interventions (SCAI) and the American College of Cardiology (ACC) Interventional Council
Affiliations

Cardiac procedural deferral during the coronavirus (COVID-19) pandemic

Celina M Yong et al. Catheter Cardiovasc Interv. 2020 Nov.

Abstract

We aimed to examine factors impacting variability in cardiac procedural deferral during the COVID-19 pandemic and assess cardiologists' perspectives regarding its implications. Unprecedented cardiac procedural deferral was implemented nationwide during the COVID-19 pandemic. A web-based survey was administered by Society for Cardiovascular Angiography and Interventions and the American College of Cardiology Interventional Council to cardiac catheterization laboratory (CCL) directors and interventional cardiologists across the United States during the COVID-19 pandemic. Among 414 total responses, 48 states and 360 unique cardiac catheterization laboratories were represented, with mean inpatient COVID-19 burden 16.4 ± 21.9%. There was a spectrum of deferral by procedure type, varying by both severity of COVID-19 burden and procedural urgency (p < .001). Percutaneous coronary intervention volumes dropped by 55% (p < .0001) and transcatheter aortic valve replacement volumes dropped by 64% (p = .004), with cardiologists reporting an increase in late presenting ST-elevation myocardial infarctions and deaths among patients waiting for transcatheter aortic valve replacement. Almost 1/3 of catheterization laboratories had at least one interventionalist testing positive for COVID-19. Salary reductions did not influence procedural deferral or speed of reinstituting normal volumes. Pandemic preparedness improved significantly over time, with the most pressing current problems focused on inadequate testing and staff health risks. During the COVID-19 pandemic, cardiac procedural deferrals were associated with procedural urgency and severity of hospital COVID-19 burden. Yet patients did not appear to be similarly influenced, with cardiologists reporting increases in late presenting ST-elevation myocardial infarctions independent of local COVID-19 burden. The safety and importance of seeking healthcare during this pandemic deserves emphasis.

Keywords: COVID-19; cardiac catheterization; pandemics; percutaneous coronary intervention.

PubMed Disclaimer

References

REFERENCES

    1. “Public Health Response to the Initiation and Spread of Pandemic COVID-19 in the United States, February 24-April 21,2020” Morbidity and Mortality Weekly Report (MMWR). Centers for Disease Control. https://www.cdc.gov/mmwr/volumes/69/wr/mm6918e2.htm. Accessed June 25, 2020.
    1. Welt F, Shah PB, Aronow HD, et al. American College of Cardiology's Interventional Council and the Society for Cardiovascular Angiography and Interventions Catheterization Laboratory considerations during the coronavirus (COVID-19) pandemic: from the ACC's interventional council and SCAI. J Am Coll Cardiol. 2020;75(18):2372-2375.
    1. VHA COVID-19 Response Plan. Office of Emergency Management. https://www.va.gov/opa/docs/VHA_COVID_19_03232020_vF_1.pdf. March 23, 2020. Accessed June 2, 2020.
    1. Centers for Disease Control and Prevention. “Coronavirus Disease 2019 (COVID-19)”. https://www-cdc-gov.laneproxy.stanford.edu/coronavirus/2019-ncov/hcp/gui.... Accessed June 16, 2020.
    1. Bhatt A, Moscone A, McElrath EE, et al. Declines in hospitalizations for acute cardiovascular conditions during the COVID-19 pandemic: a multicenter tertiary care experience. J Am Coll Cardiol. 2020;76(3):280-288.

MeSH terms

LinkOut - more resources