Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 166.39
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

Ahead of print

doi: 10.17219/acem/152636

Publication type: research letter

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Cite as:

Cierpiszewska K, Ciechanowicz S, Górecki M, Kupidłowski P, Puślecki M, Perek B. Changes in treatment of aortic valve diseases for acute and elective indications during the COVID-19 pandemic: A retrospective single-center analysis from 2019 to 2020 [published online as ahead of print on September 1, 2022]. Adv Clin Exp Med. 2022. doi:10.17219/acem/152636

Changes in treatment of aortic valve diseases for acute and elective indications during the COVID-19 pandemic: A retrospective single-center analysis from 2019 to 2020

Katarzyna Cierpiszewska1,A,B,C,D,F, Stanisław Ciechanowicz1,B,C,D,F, Maciej Górecki1,B,D,F, Piotr Kupidłowski1,B,D,F, Mateusz Puślecki2,3,A,B,D,F, Bartłomiej Perek3,D,E,F

1 Faculty of Medicine, Poznan University of Medical Sciences, Poland

2 Department of Medical Rescue, Poznan University of Medical Sciences, Poland

3 Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poland


Background. Coronavirus disease 2019 (COVID-19) pandemic had an impact on the quality of healthcare services and led to many changes in the treatment of cardiac pathologies.
Objectives. To assess the differences in the clinical manifestations, management and outcomes of patients with aortic valve diseases (AVDs) treated invasively before and during the pandemic.
Material and Methods. This retrospective single-center study involved patients with AVDs treated by means of balloon aortic valvuloplasty (BAV), transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) in 2019 and 2020. They were divided into groups with respect to the year of intervention (2019 compared to 2020) and the priority of admission (urgent compared to elective). Preoperative characteristics, early outcomes and probability of annual survival were compared between the groups.
Results. The number of patients admitted urgently increased from 37 in 2019 to 54 in 2020, with a higher prevalence of men in 2020 (83.3% compared to 56.8%, respectively). Elective cases, on the other hand, declined from 279 in 2019 to 256 in 2020. Among the latter, more subjects had manifestations of heart failure (p < 0.001), coronary artery disease (CAD; p = 0.002), hypertension (p = 0.006), as well as had a history of a stroke (p = 0.002). In the meantime, more TAVI and fewer SAVR procedures were performed in 2020 (86 compared to 127 and 192 compared to 125, respectively; p < 0.001). In 2020, TAVI individuals had risk of death (according to the EuroSCORE scale) than in 2019 (p < 0.001). The probability of annual survival was comparable (p = 0.769) among AVD patients treated before and during the coronavirus pandemic (91.3% compared to 88.3%, respectively).
Conclusion. Although during the COVID-19 pandemic more nonelective and higher-risk AVD individuals received interventional treatment, the outcomes were comparable to the pre-pandemic era (2019). Our findings support highly valuable, less invasive therapeutic methods for treating aortic pathologies during the pandemic.

Key words

outcomes, coronavirus, aortic valve replacement, transcatheter aortic valve implantation, aortic valve disease

References (23)

  1. Rennert-May E, Leal J, Thanh NX, et al. The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study. PLoS One. 2021;16(6):e0252441. doi:10.1371/journal.pone.0252441
  2. Ojetti V, Covino M, Brigida M, et al. Non-COVID diseases during the pandemic: Where have all other emergencies gone? Medicina (Kaunas). 2020;56(10):512. doi:10.3390/medicina56100512
  3. Fersia O, Bryant S, Nicholson R, et al. The impact of the COVID-19 pandemic on cardiology services. Open Heart. 2020;7(2):e001359. doi:10.1136/openhrt-2020-001359
  4. Ball S, Banerjee A, Berry C, et al. Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK. Heart. 2020;106(24):1890–1897. doi:10.1136/heartjnl-2020-317870
  5. Negreira Caamaño M, Piqueras Flores J, Mateo Gómez C. Impact of COVID-19 pandemic in cardiology admissions. Med Clin (Engl Ed). 2020;155(4):179–180. doi:10.1016/j.medcle.2020.05.006
  6. Mohamed MO, Banerjee A, Clarke S, et al. Impact of COVID-19 on cardiac procedure activity in England and associated 30-day mortality. Eur Heart J Qual Care Clin Outcomes. 2021;7(3):247–256. doi:10.1093/ehjqcco/qcaa079
  7. Lackowski P, Piasecki M, Kasprzak M, Kryś J, Niezgoda P, Kubica J. COVID-19 pandemic year in the cardiology department. Med Res J. 2021;6(1):40–46.10.5603/MRJ.a2021.0009 Accessed April 1, 2022.
  8. Sokolski M, Gajewski P, Zymliński R, et al. Impact of coronavirus disease 2019 (COVID-19) outbreak on acute admissions at the emergency and cardiology departments across Europe. Am J Med. 2021;134(4):482–489. doi:10.1016/j.amjmed.2020.08.043
  9. Juraszek A, Kuriata J, Kołsut P, et al. Literature-based considerations regarding organizing and performing cardiac surgery against the backdrop of the coronavirus pandemic. J Cardiothorac Surg. 2021;16(1):73. doi:10.1186/s13019-021-01419-9
  10. Kanwar A, Thaden JJ, Nkomo VT. Management of patients with aortic valve stenosis. Mayo Clin Proc. 2018;93(4):488–508. doi:10.1016/j.mayocp.2018.01.020
  11. Dąbrowski M, Parma R, Huczek Z, et al. The Polish Interventional Cardiology TAVI Survey (PICTS): 10 years of transcatheter aortic valve implantation in Poland. The landscape after the first stage of Valve for Life initiative. Pol Arch Intern Med. 2021;131(5):413–420. doi:10.20452/pamw.15887
  12. Andra O, Furnică C, Chistol RO, Mitu F, Leon-Constantin MM, Tinică G. Surgical versus transvalvular aortic valve replacement in elderly patients: The impact of frailty. Diagnostics (Basel). 2021;11(10):1861. doi:10.3390/diagnostics11101861
  13. Maqbool S, Kumar V, Rastogi V, Seth A. Transcatheter aortic valve implantation under conscious sedation: The first Indian experience. Indian Heart J. 2014;66(2):208–210. doi:10.1016/j.ihj.2014.02.004
  14. Vendrik J, de Boer J, Zwiers W, et al. Ongoing transcatheter aortic valve implantation (TAVI) practice amidst a global COVID-19 crisis: Nurse-led analgesia for transfemoral TAVI. Neth Heart J. 2020;28(7–8):384–386. doi:10.1007/s12471-020-01472-4
  15. Nitsche C, Koschutnik M, Kammerlander A, Hengstenberg C, Mascherbauer J. Gender-specific differences in valvular heart disease. Wien Klin Wochenschr. 2020;132(3–4):61–68. doi:10.1007/s00508-019-01603-x
  16. Lee M, You M. Avoidance of healthcare utilization in South Korea during the coronavirus disease 2019 (COVID-19) pandemic. Int J Environ Res Public Health. 2021;18(8):4363. doi:10.3390/ijerph18084363
  17. Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020;38(7):1504–1507. doi:10.1016/j.ajem.2020.04.048
  18. Babapoor-Farrokhran S, Gill D, Walker J, Rasekhi RT, Bozorgnia B, Amanullah A. Myocardial injury and COVID-19: Possible mechanisms. Life Sci. 2020;253:117723. doi:10.1016/j.lfs.2020.117723
  19. Nannoni S, de Groot R, Bell S, Markus HS. Stroke in COVID-19: A systematic review and meta-analysis. Int J Stroke. 2021;16(2):137–149. doi:10.1177/1747493020972922
  20. Chen G, Li X, Gong Z, et al. Hypertension as a sequela in patients of SARS-CoV-2 infection. PLoS One. 2021;16(4):e0250815. doi:10.1371/journal.pone.0250815
  21. Dąbrowski M, Pyłko A, Chmielak Z, et al. Comparison of transcatheter aortic valve implantation outcomes in patients aged <85 years and ≥85 years: A single-centre study. Pol Arch Intern Med. 2021;131(2):145–151. doi:10.20452/pamw.15780
  22. Martin GP, Sperrin M, Hulme W, et al. Relative survival after transcatheter aortic valve implantation: How do patients undergoing transcatheter aortic valve implantation fare relative to the general population? J Am Heart Assoc. 2017;6(10):e007229. doi:10.1161/JAHA.117.007229
  23. Zelis JM, van ’t Veer M, Houterman S, Pijls NHJ, Tonino PAL. Survival and quality of life after transcatheter aortic valve implantation relative to the general population. Int J Cardiol Heart Vasc. 2020;28:100536. doi:10.1016/j.ijcha.2020.100536