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. 2024 Feb 12;17(3):374-387.
doi: 10.1016/j.jcin.2023.10.041. Epub 2024 Jan 3.

Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study

Xavier Armario  1 , Jennifer Carron  2 , Andrew J Simpkin  3 , Mohamed Elhadi  2 , Ciara Kennedy  2 , Mohamed Abdel-Wahab  4 , Sabine Bleiziffer  5 , Thierry Lefèvre  6 , Alexander Wolf  7 , Thomas Pilgrim  8 , Pedro A Villablanca  9 , Daniel J Blackman  10 , Nicolas M Van Mieghem  11 , Christian Hengstenberg  12 , Martin J Swaans  13 , Bernard D Prendergast  14 , Tiffany Patterson  14 , Marco Barbanti  15 , John G Webb  16 , Miles Behan  17 , Jon Resar  18 , Mao Chen  19 , David Hildick-Smith  20 , Mark S Spence  21 , David Zweiker  22 , Rodrigo Bagur  23 , Rui Teles  24 , Flavio L Ribichini  25 , Dariusz Jagielak  26 , Duk-Woo Park  27 , Ran Kornowski  28 , Joanna J Wykrzykowska  29 , Matjaz Bunc  30 , Rodrigo Estévez-Loureiro  31 , Karl Poon  32 , Matthias Götberg  33 , Raban V Jeger  34 , Hüseyin Ince  35 , Erik J S Packer  36 , Marco Angelillis  37 , Luis Nombela-Franco  38 , Yingqiang Guo  19 , Mikko Savontaus  39 , Abdulrahman M Al-Moghairi  40 , Catalina Andreea Parasca  41 , Chad Kliger  42 , David Roy  43 , Levente Molnár  44 , Mariana Silva  45 , Jonathon White  46 , Masanori Yamamoto  47 , Pedro Carrilho-Ferreira  48 , Stefan Toggweiler  49 , Vassileios Voudris  50 , Yohei Ohno  51 , Inês Rodrigues  52 , Radosław Parma  53 , Soledad Ojeda  54 , Kostas Toutouzas  55 , Ander Regueiro  56 , Marek Grygier  57 , Khaled AlMerri  58 , Ignacio Cruz-González  59 , Viliam Fridrich  60 , José M de la Torre Hernández  61 , Stephane Noble  62 , Petr Kala  63 , Lluis Asmarats  64 , Ibrahim Halil Kurt  65 , Johan Bosmans  66 , Martins Erglis  67 , Ivan Casserly  68 , Dounia Iskandarani  69 , Ravinay Bhindi  70 , Joelle Kefer  71 , Wei-Hsian Yin  72 , Liesbeth Rosseel  73 , Hyo-Soo Kim  74 , Stephen O'Connor  75 , Farrel Hellig  76 , Matias Sztejfman  77 , Oscar Mendiz  78 , Andres M Pineda  79 , Ashok Seth  80 , Elton Pllaha  81 , Fabio S de Brito Jr  82 , Vilhelmas Bajoras  83 , Mohammed A Balghith  84 , Michael Lee  85 , Guering Eid-Lidt  86 , Bert Vandeloo  87 , Vinicius Daher Vaz  88 , Mirvat Alasnag  89 , Gian Paolo Ussia  90 , Edgar Tay  91 , Jorge Mayol  92 , Sengottuvelu Gunasekaran  93 , Gennaro Sardella  94 , Wacin Buddhari  95 , Hsien-Li Kao  96 , Antonio Dager  97 , Apostolos Tzikas  98 , Ingibjörg J Gudmundsdottir  99 , Ahmad Edris  100 , Luis Abel Gutiérrez Jaikel  101 , Eduardo A Arias  102 , Mohammed Al-Hijji  103 , Mehmet Ertürk  104 , César Conde-Vela  105 , Darko Boljević  106 , Adolfo Ferrero Guadagnoli  107 , Toomas Hermlin  108 , Ahmed M ElGuindy  109 , Moysés de Oliveira Lima-Filho  110 , Luciano de Moura Santos  111 , Luis Perez  112 , Gabriel Maluenda  113 , Ali Rıza Akyüz  114 , Imad A Alhaddad  115 , Haitham Amin  116 , Chak-Yu So  117 , Arif A Al Nooryani  118 , Carlos Vaca  119 , Juan Albistur  120 , Quang Ngoc Nguyen  121 , Dabit Arzamendi  64 , Eberhard Grube  122 , Thomas Modine  123 , Didier Tchétché  124 , Kentaro Hayashida  125 , Azeem Latib  126 , Raj R Makkar  127 , Nicolo Piazza  128 , Lars Søndergaard  129 , John William McEvoy  130 , Darren Mylotte  131
Affiliations
Free article

Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study

Xavier Armario et al. JACC Cardiovasc Interv. .
Free article

Abstract

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: This 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.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Lefèvre has served as a proctor for Edwards Lifesciences; and received minor fees from Boston Scientific, Terumo, and Abbott. Dr Pilgrim has received research, travel, or educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; and speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. Dr Van Mieghem has received research grant support from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic, Daiichi Sankyo, AstraZeneca, Teleflex; and advisory board fees from Abbott Vascular, Boston Scientific, Inari, JenaValve, Medtronic, Daiichi Sankyo, AstraZeneca, Siemens, Pie Medical, and Teleflex. Dr Swaans has served as a proctor/lecturer for Abbott Vascular, Boston Scientific, Bioventrix Inc, Cardiac Dimensions, Edwards Lifesciences, GE Healthcare, Medtronic, and Philips Healthcare. Dr Prendergast has received speaker/consultancy fees from Medtronic, MicroPort, Anteris, and Edwards Lifesciences. Dr Resar has received institutional research funding from Medtronic, Edwards Lifesciences, and Abbott; and served as a TAVR proctor for Medtronic. Dr Chen has served as a consultant for Venus MedTech. Dr Hildick-Smith has received research funds and speaker fees from Medtronic. Dr Spence has received TAVR proctoring and consultancy fees from Medtronic, Boston Scientific, and Edwards Lifesciences. Dr Bunc has served as a proctor for Abbott, Meril, Edwards Lifesciences, and Medtronic. Dr Molnár has served as a consultant for Medtronic and Abbott. Dr Toggweiler has served as a consultant and proctor for Medtronic, Boston Scientific, and Biosensors; has served as a proctor for Edwards Lifesciences and Abbott Vascular; has served as a consultant for Medira, Shockwave, Teleflex, atHeart Medical, Cardiac Dimensions, and Polares Medical; has received institutional research grants from Boston Scientific, Fumedica, and Novartis; has received speaker honoraria from Sanofi, AstraZeneca, ReCor Medical, and Daiichi Sankyo; and holds equity in Hi-D Imaging. Dr Ojeda has received consulting fees from Medtronic and Edwards Lifesciences; and speaker fees from Philips and Word Medica. Dr Toutouzas has served as a proctor for Medtronic, Abbott, Myval, and Boston Scientific. Dr AlMerri has served as a TAVR proctor for Medtronic. Dr Noble has served as a proctor for Medtronic; and received institutional grant support from Edwards Lifesciences, Boston Scientific, Abbott Vascular, and Medtronic. Dr Kala has served as a consultant for Boston Scientific; served on the Speakers Bureau for Edwards Lifesciences, Servier, and AstraZeneca; and received research support from Novartis. Dr Kurt has served as a TAVR proctor for Abbott. Dr Yin has served as a TAVR proctor for Medtronic, Edwards Lifesciences, and Abbott. Dr Sztejfman has served as a proctor for Boston Scientific, Edwards Lifesciences, Medtronic, Meril Life Sciences, and MicroPort. Dr Mendiz has served as a proctor for Medtronic, Boston Scientific, and Edwards Lifesciences. Dr Gunasekaran has received fees from Medtronic, Meril Life Sciences, Abbott, and Boston Scientific. Dr Kao has served as a proctor for Medtronic and Edwards Lifesciences. Dr Dager has served as a consultant for Medtronic. Dr Ferrero-Guadagnoli has served as a proctor for Boston Scientific, Edwards Lifesciences, and Medtronic. Dr Modine has served as a consultant for and received honorarium from Abbott, Medtronic, and Edwards Lifesciences. Dr Hayashida has served as a proctor for Edwards Lifesciences, Medtronic, and Abbott. Dr Makkar has received research grants from Abbott, Edwards Lifesciences, and Boston Scientific, and served as a consultant for Cordis and Medtronic. Dr Mylotte has received institutional grant funding from Boston Scientific and Medtronic; and personal fees from Boston Scientific, Medtronic, and MicroPort. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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