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. 2023 Apr 6;23(1):187.
doi: 10.1186/s12872-023-03213-y.

Impact of the COVID-19 pandemic on aortic valve replacement procedures in Germany

Adrian Heidenreich  1   2 , Peter Stachon  1   2 , Vera Oettinger  1   2 , Ingo Hilgendorf  1 , Timo Heidt  1 , Jonathan Rilinger  1 , Manfred Zehender  1   2 , Dirk Westermann  1 , Constantin von Zur Mühlen #  1   2 , Klaus Kaier #  3   4
Affiliations

Impact of the COVID-19 pandemic on aortic valve replacement procedures in Germany

Adrian Heidenreich et al. BMC Cardiovasc Disord. .

Abstract

Background: COVID-19 has caused the deferral of millions of elective procedures, likely resulting in a backlog of cases. We estimate the number of postponed surgical aortic valve replacement (sAVR) and transcatheter aortic valve replacement (TAVR) procedures during the first two waves of the COVID-19 pandemic in Germany.

Methods: Using German national records, all isolated TAVR and sAVR procedures between 2007 and 2020 were identified. Using weekly TAVR and sAVR procedures between 2017 and 2019, we created a forecast for 2020 and compared it with the observed number of procedures in 2020.

Results: In Germany, a total of 225,398 isolated sAVR and 159,638 isolated TAVR procedures were conducted between 2007 and 2020 that were included in our analysis. The reduction in all AVR procedures (sAVR and TAVR) for the entire year 2020 was 19.07% (95%CI: 15.19-22.95%). During the first wave of the pandemic (week 12-21), the mean weekly reduction was 32.06% (23.44-40.68%) and during the second wave of the pandemic (week 41-52), the mean weekly reduction was 25.58% (14.19-36.97%). The number of sAVR procedures decreased more than the number of TAVR procedures (24.63% vs. 16.42% for the entire year 2020).

Conclusion: The first year of the COVID-19 pandemic saw a substantial postponing of AVR procedures in Germany. Postponing was higher for sAVR than for TAVR procedures and less pronounced during the second wave of the COVID-19 pandemic.

Keywords: Covid-19; TAVI; sAVR.

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Conflict of interest statement

DW received fees from Abiomebd, AstraZeneca, Bayer, Boehringer Ingelheim, Berlin-Chemie, Edwards Lifescience, Medtronic, and Novartis. ALL other authors have no competing interest.

Figures

Fig. 1
Fig. 1
Number of aortic valve replacements in Germany 2007–2020 Number of all aortic valve replacements (AVR) and development of surgical (sAVR) and transcatheter (TAVR) aortic valve replacements in Germany
Fig. 2
Fig. 2
Forecasted and observed surgical aortic valve replacements in 2020 Forecasted and observed weekly number of sAVR procedures (above figure), relative difference between forecasted and observed weekly number of sAVR procedures (middle figure), and weekly number of new hospital admissions for COVID-19 per million inhabitants according to Roser et al. [18] (bottom figure)
Fig. 3
Fig. 3
Forecasted and observed transcatheter aortic valve replacements in 2020 Forecasted and observed weekly number of TAVR procedures (above figure), relative difference between forecasted and observed weekly number of TAVR procedures (middle figure), and weekly number of new hospital admissions for COVID-19 per million inhabitants according to Roser et al. [18] (bottom figure)
Fig. 4
Fig. 4
Forecasted and observed surgical and transcatheter aortic valve replacements combined in 2020 Forecasted and observed weekly number of AVR procedures (above figure), relative difference between forecasted and observed weekly number of AVR procedures (middle figure), and weekly number of new hospital admissions for COVID-19 per million inhabitants according to Roser et al. [18] (bottom figure)
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