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 selectionReview 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-upAvoid 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.
ProcedureKeep it simple.
Use devices the operator/team is familiar with.
Transfemoral procedures only.
Consider appropriateness/ethics of surgical bail-out.
Post-TAVIEarly 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.