Management of elective aortic valve replacement over the long term in the era of COVID-19

Abstract

As numerous patients await elective aortic valve intervention for aortic stenosis (AS) during this unprecedented outbreak of severe acute respiratory syndrome coronavirus 2 in 2019 (COVID-19), there is serious concern for the possibility of morbidity and mortality during prolonged wait-times. During this time period, the American College of Surgeons and Center for Disease Control released their recommendation to reschedule elective surgeries and to shift elective inpatient diagnostic and surgical procedures to the outpatient setting [1]. Accordingly, the Centers for Medicare & Medicaid Services provided a framework to further group elective surgeries into levels of urgency [2]. A tiered framework ensures that we are providing surgical services and procedures to those patients in whom the risk of delaying a procedure may lead to significant morbidity or mortality. As cardiovascular healthcare providers caring for patients with AS, we must now differentiate cases at a higher tier of urgency from the rest.