Impact of the COVID-19 Pandemic on Global TAVR Activity

• Published in: JACC. Cardiovascular interventions 2024-02, Vol.17 (3), p.374-387
• Main Authors: Armario, Xavier, Simpkin, Andrew J., Elhadi, Mohamed, Kennedy, Ciara, Abdel-Wahab, Mohamed, Lefèvre, Thierry, Pilgrim, Thomas, Villablanca, Pedro A., Blackman, Daniel J., Van Mieghem, Nicolas M., Hengstenberg, Christian, Swaans, Martin J., Prendergast, Bernard D., Patterson, Tiffany, Barbanti, Marco, Webb, John G., Resar, Jon, Chen, Mao, Hildick-Smith, David, Spence, Mark S., Zweiker, David, Bagur, Rodrigo, Jagielak, Dariusz, Park, Duk-Woo, Kornowski, Ran, Bunc, Matjaz, Götberg, Matthias, Jeger, Raban V., Ince, Hüseyin, Nombela-Franco, Luis, Al-Moghairi, Abdulrahman M., Parasca, Catalina Andreea, Kliger, Chad, Roy, David, Molnár, Levente, White, Jonathon, Carrilho-Ferreira, Pedro, Voudris, Vassileios, Ohno, Yohei, Rodrigues, Inês, Regueiro, Ander, Grygier, Marek, AlMerri, Khaled, Cruz-González, Ignacio, Fridrich, Viliam, Noble, Stephane, Kala, Petr, Asmarats, Lluis, Kurt, Ibrahim Halil, Bosmans, Johan, Erglis, Martins, Casserly, Ivan, Rosseel, Liesbeth, O'Connor, Stephen, Hellig, Farrel, Sztejfman, Matias, Mendiz, Oscar, Pineda, Andres M., Seth, Ashok, Pllaha, Elton, Bajoras, Vilhelmas, Balghith, Mohammed A., Lee, Michael, Vandeloo, Bert, Vaz, Vinicius Daher, Alasnag, Mirvat, Ussia, Gian Paolo, Tay, Edgar, Mayol, Jorge, Gunasekaran, Sengottuvelu, Sardella, Gennaro, Buddhari, Wacin, Kao, Hsien-Li, Dager, Antonio, Tzikas, Apostolos, Gudmundsdottir, Ingibjörg J., Edris, Ahmad, Arias, Eduardo A., Al-Hijji, Mohammed, Conde-Vela, César, Boljević, Darko, Ferrero Guadagnoli, Adolfo, Hermlin, Toomas, ElGuindy, Ahmed M., de Moura Santos, Luciano, Maluenda, Gabriel, Akyüz, Ali Rıza, Alhaddad, Imad A., Al Nooryani, Arif A., Vaca, Carlos, Nguyen, Quang Ngoc, Arzamendi, Dabit, Grube, Eberhard, Modine, Thomas, Tchétché, Didier, Hayashida, Kentaro, Latib, Azeem, Makkar, Raj R., Piazza, Nicolo, McEvoy, John William
• Format: Article
• Language: English
• Subjects: aortic valve stenosis; coronavirus disease 2019; transcatheter aortic valve replacement; valvular heart disease
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2023.10.041

The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses. We included 130 centers from 61 countries, including 65,980 TAVR procedures. The first and second pandemic waves were associated with a significant reduction of 15% (P < 0.001) and 7% (P < 0.001) in monthly TAVR case volume, respectively, compared with the prepandemic period. The third pandemic wave was not associated with reduced TAVR activity. A greater reduction in TAVR activity was observed in Africa (−52%; P = 0.001), Central-South America (−33%; P < 0.001), and Asia (−29%; P < 0.001). Private hospitals (P = 0.005), urban areas (P = 0.011), low-volume centers (P = 0.002), countries with lower development (P