Follow-up recommendations after valve interventions in the context of COVID-19
| Surgical interventions | Valve implanted prior to COVID-19 | Valve implanted during COVID-19 |
| Mechanical valves and bioprosthetic valves and MV repair | Annual clinical assessment via a virtual clinic TTE not routinely indicated; only perform if known abnormality on previous study under surveillance (eg, paravalvular leak, progressive rise in gradients, known transvalvular MR in a previously repaired MV) or new symptoms/signs suggestive of valve dysfunction on clinical assessment | Baseline echocardiogram just before hospital discharge Either in-person or virtual (video) consultation for surgical check-up at 6 weeks* Virtual clinic assessment at 1 year; no need for TTE if patient remains well and is asymptomatic Annual virtual clinic assessment thereafter until return to normal clinic capacity—either with hospital specialist or community cardiology team (eg, GPSI in the UK) |
| Transcatheter interventions | ||
| TAVI and MitraClip | Annual clinical assessment via a virtual clinic No need for TTE if no new symptoms and no cause for concern on last echocardiogram | Baseline echocardiogram just before hospital discharge Either in-person or virtual (video) consultation for check-up at 3 months* Virtual clinic assessment at 1 year; no need for TTE if patient remains asymptomatic and baseline TTE gave no cause for concern Annual virtual clinic assessment with hospital specialist thereafter until return to normal clinic capacity |
Suggested follow-up schedules for patients following surgical and transcatheter heart valve interventions, performed either prior to the COVID-19 pandemic or during this period.
*Denotes timepoints when, ideally, an ECG would be recorded at follow-up: if patients are not coming to the hospital for follow-up, this may be possible via their family doctor/general practitioner.
GPSI, general practitioner with specialist interest; MR, mitral regurgitation; MV, mitral valve; TTE, transthoracic echocardiogram.