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. 2020 Jun 10;106(15):1183–1190. doi: 10.1136/heartjnl-2020-317221

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.