Author + information
- Varsha K. Tanguturi, MD1,∗ (, )
- Brian R. Lindman, MD MSC2,
- Philippe Pibarot, DVM PHD3,
- Jonathan J. Passeri, MD1,
- Samir Kapadia, MD4,
- Michael J. Mack, MD5,
- Ignacio Inglessis, MD1,
- Nathan B. Langer, MD6,
- Thoralf M. Sundt, MD6,
- Judy Hung, MD1 and
- Sammy Elmariah, MD MPH1,∗∗ ()
- 1Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard, Medical School, Boston, MA, USA
- 2Structural Heart and Valve Center, Vanderbilt University School of Medicine, Nashville, TN, USA
- 3Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Québec City, Québec, Canada
- 4Department of Medicine, Cleveland Clinic, Clevelanfd, OH, 44195, USA
- 5Baylor Scott & White Health, Dallas, TX
- 6Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- ↵∗Address for Correspondence: Varsha K. Tanguturi MD Massachusetts General Hospital 55 Fruit Street | Yawkey 5B Boston, MA 02114 Tel: (617) 724-0359 Fax: (617) 643-1620
- ↵∗∗Address for Correspondence: Sammy Elmariah MD MPH, Massachusetts General Hospital, 55 Fruit Street | Bigelow 800 , Boston, MA 02114, Tel: 617-726-6120 Fax: 617-726-9839
The novel coronavirus-19 (COVID-19) pandemic has created uncertainty in the management of patients with severe aortic stenosis (AS). This population experiences high mortality from delays in treatment of valve disease but is largely overlapping with the population of highest mortality from COVID-19. We present strategies for managing patients with severe AS in the COVID-era. We suggest transitions to virtual assessments and consultation, careful pruning and planning of necessary testing, as well as fewer and shorter hospital admissions. These strategies center on minimizing patient exposure to COVID-19 and expenditure of human and health-care resources without significant sacrifice to patient outcomes during this public health emergency. Areas of innovation to improve our care during this time include increased use of 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.
Dr. Passeri has received institutional research support from Edwards Lifesciences; has been a speaker at an educational symposium sponsored by Medtronic; and has received consulting fees from Medtronic.
Dr. Mack served as co-primary investigator for the PARTNER Trial for Edwards Lifesciences and COAPT trial for Abbott; served as study chair for the APOLLO trial for Medtronic.
Dr. Inglessis has received institutional research support from Medtronic, St. Jude Medical, and W.L. Gore and Associates; and is a proctor for Medtronic and Edwards Lifesciences.
Dr. Hung receives support from the National Institutes of Health (R01 HL141917).
Dr. Elmariah has received research grants from American Heart Association (19TPA34910170), National Institutes of Health (R01 HL151838), Edwards Lifesciences, Svelte Medical, and Medtronic; and has received consulting fees from AstraZeneca.
All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Tweet/handle: @vktanguturi @SammyElmariahMD; Aortic stenosis is complicated. It’s only more complicated in the COVID era! Check out our strategies for managing severe AS during the COVID pandemic in #JACCINT
- Received April 23, 2020.
- Revision received May 22, 2020.
- Accepted May 26, 2020.