During the COVID-19 pandemic, transitioning to virtual assessments and consultations, careful pruning and planning of necessary testing, and fewer and shorter hospital admissions are strategies that can minimize exposure of patients with severe aortic stenosis (AS) to COVID-19 and expenditure of human and health care resources without significant sacrifice of patient outcomes, according to a viewpoint published in JACC: Cardiovascular Interventions.

Varsha K. Tanguturi, MD, et al., present clinical strategies for the management of patients with severe AS during the COVID-19 pandemic as care for this patient population has been particularly challenging due to high-resource utilization and increased mortality from delays in care, along with substantial risk of poor outcomes from COVID-19 infection.

The authors offer clinical guidance on outpatient surveillance and risk stratification, aortic valve replacement (AVR) evaluation, consideration of surgical AVR vs. transcatheter AVR, postprocedural care after AVR, and the management of severe AS patients who contract COVID-19. They suggest that areas of innovation that can be harnessed to improve care for these patients during the pandemic include wearable and remote devices to assess patient performance and vital signs; devices for facile cardiac assessment; and widespread use of clinical protocols for expedient discharge with virtual physical therapy and cardiac rehabilitation options.

"The duration of this public health emergency remains uncertain and thus investment in innovative [health care] technologies is critical," write the authors. "Improved virtual platforms that allow for transmission of blood pressure reading, tracking of physical activity, and widespread use of home-electrocardiogram (ECG) platforms or digital stethoscopes with recordable audio would allow for a more complete remote clinical assessment."

Clinical Topics: Cardiac Surgery, Cardiovascular Care Team, COVID-19 Hub, Valvular Heart Disease, Aortic Surgery, Cardiac Surgery and VHD

Keywords: COVID-19, Pandemics, Aortic Valve, Cardiac Rehabilitation, Patient Discharge, Health Expenditures, Public Health, Blood Pressure, Outpatients, Reading, Stethoscopes, severe acute respiratory syndrome coronavirus 2, Aortic Valve Stenosis, Heart Valve Prosthesis, Emergency Service, Hospital

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