Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study

Xavier Armario; Jennifer Carron; Andrew J. Simpkin; Mohamed Elhadi; Ciara Kennedy; Mohamed Abdel-Wahab; Sabine Bleiziffer; Thierry Lefèvre; Alexander Wolf; Thomas Pilgrim; Pedro A. Villablanca; Daniel J. Blackman; Nicolas M. Van Mieghem; Christian Hengstenberg; Martin J. Swaans; Bernard D. Prendergast; Tiffany Patterson; Marco Barbanti; John G. Webb; Miles Behan; Jon Resar; Mao Chen; David Hildick-Smith; Mark S. Spence; David Zweiker; Rodrigo Bagur; Rui Teles; Flavio L. Ribichini; Dariusz Jagielak; Duk Woo Park; Ran Kornowski; Joanna J. Wykrzykowska; Matjaz Bunc; Rodrigo Estévez-Loureiro; Karl Poon; Matthias Götberg; Raban V. Jeger; Hüseyin Ince; Erik J.S. Packer; Marco Angelillis; Luis Nombela-Franco; Yingqiang Guo; Mikko Savontaus; Abdulrahman M. Al-Moghairi; Catalina Andreea Parasca; Chad Kliger; David Roy; Levente Molnár; Mariana Silva; Jonathon White; Masanori Yamamoto; Pedro Carrilho-Ferreira; Stefan Toggweiler; Vassileios Voudris; Yohei Ohno; Inês Rodrigues; Radosław Parma; Soledad Ojeda; Kostas Toutouzas; Ander Regueiro; Marek Grygier; Khaled AlMerri; Ignacio Cruz-González; Viliam Fridrich; José M. de la Torre Hernández; Stephane Noble; Petr Kala; Lluis Asmarats; Ibrahim Halil Kurt; Johan Bosmans; Martins Erglis; Ivan Casserly; Dounia Iskandarani; Ravinay Bhindi; Joelle Kefer; Wei Hsian Yin; Liesbeth Rosseel; Hyo Soo Kim; Stephen O'Connor; Farrel Hellig; Matias Sztejfman; Oscar Mendiz; Andres M. Pineda; Ashok Seth; Elton Pllaha; Fabio S. de Brito; Vilhelmas Bajoras; Mohammed A. Balghith; Michael Lee; Guering Eid-Lidt; Bert Vandeloo; Vinicius Daher Vaz; Mirvat Alasnag; Gian Paolo Ussia; Edgar Tay; Jorge Mayol; Sengottuvelu Gunasekaran; Gennaro Sardella; Wacin Buddhari; Hsien Li Kao; Antonio Dager; Apostolos Tzikas; Ingibjörg J. Gudmundsdottir; Ahmad Edris; Luis Abel Gutiérrez Jaikel; Eduardo A. Arias; Mohammed Al-Hijji; Mehmet Ertürk; César Conde-Vela; Darko Boljević; Adolfo Ferrero Guadagnoli; Toomas Hermlin; Ahmed M. ElGuindy; Moysés de Oliveira Lima-Filho; Luciano de Moura Santos; Luis Perez; Gabriel Maluenda; Ali Rıza Akyüz; Imad A. Alhaddad; Haitham Amin; Chak Yu So; Arif A. Al Nooryani; Carlos Vaca; Juan Albistur; Quang Ngoc Nguyen; Dabit Arzamendi; Eberhard Grube; Thomas Modine; Didier Tchétché; Kentaro Hayashida; Azeem Latib; Raj R. Makkar; Nicolo Piazza; Lars Søndergaard; John William McEvoy; Darren Mylotte

doi:10.1016/j.jcin.2023.10.041

Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study

Xavier Armario, Jennifer Carron, Andrew J. Simpkin, Mohamed Elhadi, Ciara Kennedy, Mohamed Abdel-Wahab, Sabine Bleiziffer, Thierry Lefèvre, Alexander Wolf, Thomas Pilgrim, Pedro A. Villablanca, Daniel J. Blackman, Nicolas M. Van Mieghem, Christian Hengstenberg, Martin J. Swaans, Bernard D. Prendergast, Tiffany Patterson, Marco Barbanti, John G. Webb, Miles BehanJon Resar, Mao Chen, David Hildick-Smith, Mark S. Spence, David Zweiker, Rodrigo Bagur, Rui Teles, Flavio L. Ribichini, Dariusz Jagielak, Duk Woo Park, Ran Kornowski, Joanna J. Wykrzykowska, Matjaz Bunc, Rodrigo Estévez-Loureiro, Karl Poon, Matthias Götberg, Raban V. Jeger, Hüseyin Ince, Erik J.S. Packer, Marco Angelillis, Luis Nombela-Franco, Yingqiang Guo, Mikko Savontaus, Abdulrahman M. Al-Moghairi, Catalina Andreea Parasca, Chad Kliger, David Roy, Levente Molnár, Mariana Silva, Jonathon White, Masanori Yamamoto, Pedro Carrilho-Ferreira, Stefan Toggweiler, Vassileios Voudris, Yohei Ohno, Inês Rodrigues, Radosław Parma, Soledad Ojeda, Kostas Toutouzas, Ander Regueiro, Marek Grygier, Khaled AlMerri, Ignacio Cruz-González, Viliam Fridrich, José M. de la Torre Hernández, Stephane Noble, Petr Kala, Lluis Asmarats, Ibrahim Halil Kurt, Johan Bosmans, Martins Erglis, Ivan Casserly, Dounia Iskandarani, Ravinay Bhindi, Joelle Kefer, Wei Hsian Yin, Liesbeth Rosseel, Hyo Soo Kim, Stephen O'Connor, Farrel Hellig, Matias Sztejfman, Oscar Mendiz, Andres M. Pineda, Ashok Seth, Elton Pllaha, Fabio S. de Brito, Vilhelmas Bajoras, Mohammed A. Balghith, Michael Lee, Guering Eid-Lidt, Bert Vandeloo, Vinicius Daher Vaz, Mirvat Alasnag, Gian Paolo Ussia, Edgar Tay, Jorge Mayol, Sengottuvelu Gunasekaran, Gennaro Sardella, Wacin Buddhari, Hsien Li Kao, Antonio Dager, Apostolos Tzikas, Ingibjörg J. Gudmundsdottir, Ahmad Edris, Luis Abel Gutiérrez Jaikel, Eduardo A. Arias, Mohammed Al-Hijji, Mehmet Ertürk, César Conde-Vela, Darko Boljević, Adolfo Ferrero Guadagnoli, Toomas Hermlin, Ahmed M. ElGuindy, Moysés de Oliveira Lima-Filho, Luciano de Moura Santos, Luis Perez, Gabriel Maluenda, Ali Rıza Akyüz, Imad A. Alhaddad, Haitham Amin, Chak Yu So, Arif A. Al Nooryani, Carlos Vaca, Juan Albistur, Quang Ngoc Nguyen, Dabit Arzamendi, Eberhard Grube, Thomas Modine, Didier Tchétché, Kentaro Hayashida, Azeem Latib, Raj R. Makkar, Nicolo Piazza, Lars Søndergaard, John William McEvoy, Darren Mylotte^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays.

Objectives: This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity.

Methods: 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.

Results: 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 < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity.

Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.

Original language	English
Pages (from-to)	374-387
Number of pages	14
Journal	JACC: Cardiovascular Interventions
Volume	17
Issue number	3
DOIs	https://doi.org/10.1016/j.jcin.2023.10.041
Publication status	Published - 12-Feb-2024

Keywords

aortic valve stenosis
coronavirus disease 2019
transcatheter aortic valve replacement
valvular heart disease

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Impact of the COVID-19 Pandemic on Global TAVR ActivityFinal publisher's version, 1.33 MBLicence: Taverne

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Armario, X., Carron, J., Simpkin, A. J., Elhadi, M., Kennedy, C., Abdel-Wahab, M., Bleiziffer, S., Lefèvre, T., Wolf, A., Pilgrim, T., Villablanca, P. A., Blackman, D. J., Van Mieghem, N. M., Hengstenberg, C., Swaans, M. J., Prendergast, B. D., Patterson, T., Barbanti, M., Webb, J. G., ... Mylotte, D. (2024). Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study. JACC: Cardiovascular Interventions, 17(3), 374-387. https://doi.org/10.1016/j.jcin.2023.10.041

@article{cdd2632931224aa48736e47d5882650c,

title = "Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study",

abstract = "Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. Objectives: This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. Methods: 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. Results: 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 < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity. Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.",

keywords = "aortic valve stenosis, coronavirus disease 2019, transcatheter aortic valve replacement, valvular heart disease",

author = "Xavier Armario and Jennifer Carron and Simpkin, {Andrew J.} and Mohamed Elhadi and Ciara Kennedy and Mohamed Abdel-Wahab and Sabine Bleiziffer and Thierry Lef{\`e}vre and Alexander Wolf and Thomas Pilgrim and Villablanca, {Pedro A.} and Blackman, {Daniel J.} and {Van Mieghem}, {Nicolas M.} and Christian Hengstenberg and Swaans, {Martin J.} and Prendergast, {Bernard D.} and Tiffany Patterson and Marco Barbanti and Webb, {John G.} and Miles Behan and Jon Resar and Mao Chen and David Hildick-Smith and Spence, {Mark S.} and David Zweiker and Rodrigo Bagur and Rui Teles and Ribichini, {Flavio L.} and Dariusz Jagielak and Park, {Duk Woo} and Ran Kornowski and Wykrzykowska, {Joanna J.} and Matjaz Bunc and Rodrigo Est{\'e}vez-Loureiro and Karl Poon and Matthias G{\"o}tberg and Jeger, {Raban V.} and H{\"u}seyin Ince and Packer, {Erik J.S.} and Marco Angelillis and Luis Nombela-Franco and Yingqiang Guo and Mikko Savontaus and Al-Moghairi, {Abdulrahman M.} and Parasca, {Catalina Andreea} and Chad Kliger and David Roy and Levente Moln{\'a}r and Mariana Silva and Jonathon White and Masanori Yamamoto and Pedro Carrilho-Ferreira and Stefan Toggweiler and Vassileios Voudris and Yohei Ohno and In{\^e}s Rodrigues and Rados{\l}aw Parma and Soledad Ojeda and Kostas Toutouzas and Ander Regueiro and Marek Grygier and Khaled AlMerri and Ignacio Cruz-Gonz{\'a}lez and Viliam Fridrich and {de la Torre Hern{\'a}ndez}, {Jos{\'e} M.} and Stephane Noble and Petr Kala and Lluis Asmarats and Kurt, {Ibrahim Halil} and Johan Bosmans and Martins Erglis and Ivan Casserly and Dounia Iskandarani and Ravinay Bhindi and Joelle Kefer and Yin, {Wei Hsian} and Liesbeth Rosseel and Kim, {Hyo Soo} and Stephen O'Connor and Farrel Hellig and Matias Sztejfman and Oscar Mendiz and Pineda, {Andres M.} and Ashok Seth and Elton Pllaha and {de Brito}, {Fabio S.} and Vilhelmas Bajoras and Balghith, {Mohammed A.} and Michael Lee and Guering Eid-Lidt and Bert Vandeloo and Vaz, {Vinicius Daher} and Mirvat Alasnag and Ussia, {Gian Paolo} and Edgar Tay and Jorge Mayol and Sengottuvelu Gunasekaran and Gennaro Sardella and Wacin Buddhari and Kao, {Hsien Li} and Antonio Dager and Apostolos Tzikas and Gudmundsdottir, {Ingibj{\"o}rg J.} and Ahmad Edris and {Guti{\'e}rrez Jaikel}, {Luis Abel} and Arias, {Eduardo A.} and Mohammed Al-Hijji and Mehmet Ert{\"u}rk and C{\'e}sar Conde-Vela and Darko Boljevi{\'c} and {Ferrero Guadagnoli}, Adolfo and Toomas Hermlin and ElGuindy, {Ahmed M.} and Lima-Filho, {Moys{\'e}s de Oliveira} and {de Moura Santos}, Luciano and Luis Perez and Gabriel Maluenda and Aky{\"u}z, {Ali Rıza} and Alhaddad, {Imad A.} and Haitham Amin and So, {Chak Yu} and {Al Nooryani}, {Arif A.} and Carlos Vaca and Juan Albistur and Nguyen, {Quang Ngoc} and Dabit Arzamendi and Eberhard Grube and Thomas Modine and Didier Tch{\'e}tch{\'e} and Kentaro Hayashida and Azeem Latib and Makkar, {Raj R.} and Nicolo Piazza and Lars S{\o}ndergaard and McEvoy, {John William} and Darren Mylotte",

note = "Publisher Copyright: {\textcopyright} 2024 American College of Cardiology Foundation",

year = "2024",

month = feb,

day = "12",

doi = "10.1016/j.jcin.2023.10.041",

language = "English",

volume = "17",

pages = "374--387",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

publisher = "ELSEVIER SCIENCE INC",

number = "3",

}

Armario, X, Carron, J, Simpkin, AJ, Elhadi, M, Kennedy, C, Abdel-Wahab, M, Bleiziffer, S, Lefèvre, T, Wolf, A, Pilgrim, T, Villablanca, PA, Blackman, DJ, Van Mieghem, NM, Hengstenberg, C, Swaans, MJ, Prendergast, BD, Patterson, T, Barbanti, M, Webb, JG, Behan, M, Resar, J, Chen, M, Hildick-Smith, D, Spence, MS, Zweiker, D, Bagur, R, Teles, R, Ribichini, FL, Jagielak, D, Park, DW, Kornowski, R, Wykrzykowska, JJ, Bunc, M, Estévez-Loureiro, R, Poon, K, Götberg, M, Jeger, RV, Ince, H, Packer, EJS, Angelillis, M, Nombela-Franco, L, Guo, Y, Savontaus, M, Al-Moghairi, AM, Parasca, CA, Kliger, C, Roy, D, Molnár, L, Silva, M, White, J, Yamamoto, M, Carrilho-Ferreira, P, Toggweiler, S, Voudris, V, Ohno, Y, Rodrigues, I, Parma, R, Ojeda, S, Toutouzas, K, Regueiro, A, Grygier, M, AlMerri, K, Cruz-González, I, Fridrich, V, de la Torre Hernández, JM, Noble, S, Kala, P, Asmarats, L, Kurt, IH, Bosmans, J, Erglis, M, Casserly, I, Iskandarani, D, Bhindi, R, Kefer, J, Yin, WH, Rosseel, L, Kim, HS, O'Connor, S, Hellig, F, Sztejfman, M, Mendiz, O, Pineda, AM, Seth, A, Pllaha, E, de Brito, FS, Bajoras, V, Balghith, MA, Lee, M, Eid-Lidt, G, Vandeloo, B, Vaz, VD, Alasnag, M, Ussia, GP, Tay, E, Mayol, J, Gunasekaran, S, Sardella, G, Buddhari, W, Kao, HL, Dager, A, Tzikas, A, Gudmundsdottir, IJ, Edris, A, Gutiérrez Jaikel, LA, Arias, EA, Al-Hijji, M, Ertürk, M, Conde-Vela, C, Boljević, D, Ferrero Guadagnoli, A, Hermlin, T, ElGuindy, AM, Lima-Filho, MDO, de Moura Santos, L, Perez, L, Maluenda, G, Akyüz, AR, Alhaddad, IA, Amin, H, So, CY, Al Nooryani, AA, Vaca, C, Albistur, J, Nguyen, QN, Arzamendi, D, Grube, E, Modine, T, Tchétché, D, Hayashida, K, Latib, A, Makkar, RR, Piazza, N, Søndergaard, L, McEvoy, JW & Mylotte, D 2024, 'Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study', JACC: Cardiovascular Interventions, vol. 17, no. 3, pp. 374-387. https://doi.org/10.1016/j.jcin.2023.10.041

TY - JOUR

T1 - Impact of the COVID-19 Pandemic on Global TAVR Activity

T2 - The COVID-TAVI Study

AU - Armario, Xavier

AU - Carron, Jennifer

AU - Simpkin, Andrew J.

AU - Elhadi, Mohamed

AU - Kennedy, Ciara

AU - Abdel-Wahab, Mohamed

AU - Bleiziffer, Sabine

AU - Lefèvre, Thierry

AU - Wolf, Alexander

AU - Pilgrim, Thomas

AU - Villablanca, Pedro A.

AU - Blackman, Daniel J.

AU - Van Mieghem, Nicolas M.

AU - Hengstenberg, Christian

AU - Swaans, Martin J.

AU - Prendergast, Bernard D.

AU - Patterson, Tiffany

AU - Barbanti, Marco

AU - Webb, John G.

AU - Behan, Miles

AU - Resar, Jon

AU - Chen, Mao

AU - Hildick-Smith, David

AU - Spence, Mark S.

AU - Zweiker, David

AU - Bagur, Rodrigo

AU - Teles, Rui

AU - Ribichini, Flavio L.

AU - Jagielak, Dariusz

AU - Park, Duk Woo

AU - Kornowski, Ran

AU - Wykrzykowska, Joanna J.

AU - Bunc, Matjaz

AU - Estévez-Loureiro, Rodrigo

AU - Poon, Karl

AU - Götberg, Matthias

AU - Jeger, Raban V.

AU - Ince, Hüseyin

AU - Packer, Erik J.S.

AU - Angelillis, Marco

AU - Nombela-Franco, Luis

AU - Guo, Yingqiang

AU - Savontaus, Mikko

AU - Al-Moghairi, Abdulrahman M.

AU - Parasca, Catalina Andreea

AU - Kliger, Chad

AU - Roy, David

AU - Molnár, Levente

AU - Silva, Mariana

AU - White, Jonathon

AU - Yamamoto, Masanori

AU - Carrilho-Ferreira, Pedro

AU - Toggweiler, Stefan

AU - Voudris, Vassileios

AU - Ohno, Yohei

AU - Rodrigues, Inês

AU - Parma, Radosław

AU - Ojeda, Soledad

AU - Toutouzas, Kostas

AU - Regueiro, Ander

AU - Grygier, Marek

AU - AlMerri, Khaled

AU - Cruz-González, Ignacio

AU - Fridrich, Viliam

AU - de la Torre Hernández, José M.

AU - Noble, Stephane

AU - Kala, Petr

AU - Asmarats, Lluis

AU - Kurt, Ibrahim Halil

AU - Bosmans, Johan

AU - Erglis, Martins

AU - Casserly, Ivan

AU - Iskandarani, Dounia

AU - Bhindi, Ravinay

AU - Kefer, Joelle

AU - Yin, Wei Hsian

AU - Rosseel, Liesbeth

AU - Kim, Hyo Soo

AU - O'Connor, Stephen

AU - Hellig, Farrel

AU - Sztejfman, Matias

AU - Mendiz, Oscar

AU - Pineda, Andres M.

AU - Seth, Ashok

AU - Pllaha, Elton

AU - de Brito, Fabio S.

AU - Bajoras, Vilhelmas

AU - Balghith, Mohammed A.

AU - Lee, Michael

AU - Eid-Lidt, Guering

AU - Vandeloo, Bert

AU - Vaz, Vinicius Daher

AU - Alasnag, Mirvat

AU - Ussia, Gian Paolo

AU - Tay, Edgar

AU - Mayol, Jorge

AU - Gunasekaran, Sengottuvelu

AU - Sardella, Gennaro

AU - Buddhari, Wacin

AU - Kao, Hsien Li

AU - Dager, Antonio

AU - Tzikas, Apostolos

AU - Gudmundsdottir, Ingibjörg J.

AU - Edris, Ahmad

AU - Gutiérrez Jaikel, Luis Abel

AU - Arias, Eduardo A.

AU - Al-Hijji, Mohammed

AU - Ertürk, Mehmet

AU - Conde-Vela, César

AU - Boljević, Darko

AU - Ferrero Guadagnoli, Adolfo

AU - Hermlin, Toomas

AU - ElGuindy, Ahmed M.

AU - Lima-Filho, Moysés de Oliveira

AU - de Moura Santos, Luciano

AU - Perez, Luis

AU - Maluenda, Gabriel

AU - Akyüz, Ali Rıza

AU - Alhaddad, Imad A.

AU - Amin, Haitham

AU - So, Chak Yu

AU - Al Nooryani, Arif A.

AU - Vaca, Carlos

AU - Albistur, Juan

AU - Nguyen, Quang Ngoc

AU - Arzamendi, Dabit

AU - Grube, Eberhard

AU - Modine, Thomas

AU - Tchétché, Didier

AU - Hayashida, Kentaro

AU - Latib, Azeem

AU - Makkar, Raj R.

AU - Piazza, Nicolo

AU - Søndergaard, Lars

AU - McEvoy, John William

AU - Mylotte, Darren

PY - 2024/2/12

Y1 - 2024/2/12

N2 - Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. Objectives: This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. Methods: 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. Results: 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 < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity. Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.

AB - Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. Objectives: This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. Methods: 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. Results: 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 < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity. Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.

KW - aortic valve stenosis

KW - coronavirus disease 2019

KW - transcatheter aortic valve replacement

KW - valvular heart disease

UR - http://www.scopus.com/inward/record.url?scp=85184040813&partnerID=8YFLogxK

U2 - 10.1016/j.jcin.2023.10.041

DO - 10.1016/j.jcin.2023.10.041

M3 - Article

C2 - 38180419

AN - SCOPUS:85184040813

SN - 1936-8798

VL - 17

SP - 374

EP - 387

JO - JACC: Cardiovascular Interventions

JF - JACC: Cardiovascular Interventions

IS - 3

ER -

Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study

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