Table 1.
Factors to consider doing differently along the patient pathway for AS during the COVID-19 crisis
| Phase of patient pathway | Alterations to practice during the COVID-19 crisis |
| Case selection | Review TAVI waiting list and triage for highest risk. |
| Review sAVR waiting list. | |
| Convert intermediate risk patients to TAVI if appropriate. | |
| Convert low-risk patients to TAVI only with Heart Team consensus. | |
| Consider risk to patient of nosocomial COVID-19 infection. | |
| TAVI work-up | Avoid TOE. |
| Use CTCA instead of invasive coronary angiography. | |
| Consider risk to patient of COVID-19 when attending for tests. | |
| Do all tests in a single attendance. | |
| Procedure | Keep it simple. |
| Use devices the operator/team is familiar with. | |
| Transfemoral procedures only. | |
| Consider appropriateness/ethics of surgical bail-out. | |
| Post-TAVI | Early safe discharge. |
| No need for follow-up echo until 6 months. |
CTCA, CT coronary angiogram; sAVR, surgical valve replacement; TAVI, transcatheter aortic valve implantation; TOE, transoesophageal echo.