Table 2.

Suggested workflow for structural heart disease management during COVID-19 pandemic.

	New office consult, diagnostic cath and interventional procedure	Post-procedure follow up
Transcutaneous aortic valve implantation (TAVI)	Postpone unless - Symptomatic with aortic valve area <0.5 cm2, or - Heart failure hospitalization within prior 6 months, or - Compelling social reasons (e.g. need support from other family members)	Keep 1-week post-TAVR visit. Postpone or do by telemedicine: 1-month, 6-month and 1-year post-TAVI appointments. Postpone echocardiograms unless patient is symptomatic
Left atrial appendage closure (LAAC)	Postpone all new appointments and planned cases, unless compelling social reasons	- Postpone or do by telemedicine: all follow up visits, including all 45-day post LAAC trans-esophageal echocardiograms (TEEs). - In selected cases, clinicians may stop oral anti-coagulation at 45 days, until TEE can be rescheduled. - Consider computed tomographic angiography to rule out LAA clot.
Percutaneous mitral valve repair	Postpone unless HF hospitalization within prior 6 months, or compelling social reasons	Postpone or do by telemedicine: 1-month follow up and echocardiograms, unless patient has symptoms of HF
Patent foramen ovale/atrial septal defect closure	Postpone all new appointments and planned cases, unless compelling social reasons	- Postpone or do by telemedicine: all follow up visits, and post-implant TEE. - Perform Trans-thoracic echocardiography (TTE) for assessment of closure. If TTE suggests complete closure, switch dual anti-platelet therapy to single anti-platelet therapy.