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. 2020 Dec 23;22(Suppl Pt t):P38-P41.
doi: 10.1093/eurheartj/suaa184. eCollection 2020 Dec.

Patient with heart failure: importance to treat valvular diseases

Marianna Adamo  1 , Benjamin Alos  2 , Marco Metra  1 , Thierry Lefèvre  3 , Martins J Swaans  4 , Livia Gheorghe  4 , Carsten Tschöpe  5   6 , Florian Krackhardt  5 , Ottavio Alfieri  7 , Claire Bouleti  2   8
Affiliations

Patient with heart failure: importance to treat valvular diseases

Marianna Adamo et al. Eur Heart J Suppl. .

Abstract

COVID-19 pandemic is causing an unprecedented burden on healthcare resources and this includes treatment of heart failure and valvular heart diseases (VHD). Percutaneous procedures have broadened the number of patients with VHD who could be treated. However, COVID-19 pandemic has challenged their implementation. The risk of in-hospital infection, resources reallocation, reduced access to hospital caused a substantial delay of VHD treatment with an increased risk of clinical worsening and mortality. Now, the pandemic is not ended and subsequent waves are likely. Reorganization of our healthcare resources is needed, including a proper algorithm for patients' prioritization, based on the severity of their valve disease, their life expectancy, complexity of the intervention, and the resources available. A wider use of telemedicine for patients' selection and follow-up and any measurement that can shorten the duration of the hospital stay must be adopted. Patients' and healthcare staff screening for COVID-19 and all needed procedures to prevent infection will continue to be mandatory. Percutaneous procedures, compared to surgery, are associated with a lower risk of infection and a lower need for in-hospital resources, including a shorter duration of hospital stay. This may favour their adoption when the risk of viral infection is high.

Keywords: COVID-19; Heart failure; Valve disease.

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Figures

Figure 1
Figure 1
Categorization of patients with heart failure and valvular heart diseases by priority of intervention after COVID-19 pandemic. aVery severe aortic stenosis = AVA <0.6 cm2 and/or peak gradient >60 mmHg or peak velocity >5 m/s. AR, aortic regurgitation; AS, aortic stenosis; HF, heart failure; LV, left ventricular; MR, mitral regurgitation; MS, mitral stenosis; NYHA, New York Heart Association; RV, right ventricular; TR, tricuspid regurgitation.
See this image and copyright information in PMC

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