TAVI: A Blessing for Critical Heart Patients during the Pandemic
What is TAVI?
Transcatheter Aortic Valve Implantation, or TAVI, is a minimally invasive surgical treatment that inserts new aortic valves into the heart to replace any that have become constricted or damaged. The main purpose of this procedure is to cure severe aortic stenosis (AS). The aortic valve narrows significantly in AS, obstructing blood flow to the rest of the body through it. It can result in heart failure or sudden cardiac death and cause chest pain, exhaustion, shortness of breath, etc. As a first-line treatment option for AS, TAVI is becoming more and more common. This contrasts with the previously used traditional therapy, which was surgical aortic valve replacement (SAVR).
Who are Critical Heart Patients?
This patient category mainly consists of patients with valvular heart diseases and coronary heart diseases. As the word “critical” implies, these patients will not survive for long if urgent intervention is not done. From these two, valvular heart diseases are of two categories. They are congenital and acquired valvular heart diseases.
Acquired valvular heart diseases like aortic stenosis (AS) and mitral stenosis (MS) are among the most prevalent and important heart diseases and thus, it has gotten the attention of the stakeholders who are responsible for developing treatment methods for them.
TAVI and TMVR have been developed for treating these patients with varying degrees of AS and MS as valve replacement procedures. The value of these procedures being performed uninterruptedly in any situation lies in the fact that patients with severe As or MS have a poor prognosis if left untreated.
Therefore, we must take a good look at what has happened during the latest pandemic, COVID-19.
TAVI and COVID-19
Millions of people have died because of the global pandemic caused by the coronavirus disease 2019 (COVID-19), placing a significant load on healthcare. Along with the COVID-related deaths, a significant number of patients with serious illnesses have been delayed or denied access to emergency departments out of fear of encountering COVID-19 carriers and becoming infected. This has led to an increase in mortality of many patients, particularly those with cardiovascular diseases.
When we consider recent hospital base studies, some suggest that despite TAVI offering a less invasive treatment with fast recovery for these patients, imposed health-care restrictions related to COVID-19 pandemic needs let a not-negligible portion of TAVI candidates to be deferred during pandemic waves, worsening the outcomes of these patients.
Even with these difficulties, The COVID-19 pandemic led to the development of improved single-hospitalization logistics for TAVI workup and procedures, which have since proven to be as safe and efficient as the two-stage TAVI pathway previously used. This has reduced the risk of COVID-19 infection exposure and sped up treatment times for patients with severe symptoms across multiple centers renowned for performing TAVI.
Even though the COVId-19 pandemic has affected to rate of performing TAVI procedures, some bright sparks like optimized models being developed to relieve healthcare system overload could be seen. As a result of this, the TAVI procedure became a boon for critical heart patients in this difficult pandemic era.
- What is TAVR? (TAVI) | American Heart Association. Accessed June 24, 2022. https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options/what-is-tavr
- Reddavid C, Costa G, Valvo R, et al. Transcatheter aortic valve implantation during COVID-19 pandemic: An optimized model to relieve healthcare system overload. Int J Cardiol. 2022;352:190. doi:10.1016/J.IJCARD.2022.01.038