Dataset Information

Ambulatory TAVR: Early Feasibility Experience During the COVID-19 Pandemic.

ABSTRACT: The COVID-19 pandemic has modified practice for patients with symptomatic aortic stenosis and could result in higher mortality rates due to treatment delays. In this clinical case series, 3 patients underwent ambulatory transcatheter aortic valve replacement (TAVR) thanks to patient and entourage willingness, careful patient selection (including a history of permanent pacemaker placement), and a minimalist procedural approach. No complications occurred during the 30-day follow-up. Performing ambulatory TAVR could reduce the clinical consequences of wait times, minimize exposure to coronavirus contamination, and reduce the use of hospital resources that might be needed for COVID-19 patients. Thanks to a scrupulous minimalist TAVR protocol, ambulatory outpatient management of aortic stenosis was possible in the context of the COVID-19 pandemic.

SUBMITTER: Zouaghi O

PROVIDER: S-EPMC7442149 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Ambulatory TAVR: Early Feasibility Experience During the COVID-19 Pandemic.

Zouaghi Oualid O Wintzer-Wehekind Jérôme J Lienhart Yves Y Abdellaoui Mohamed M Faurie Benjamin B

CJC open 20200821 6

The COVID-19 pandemic has modified practice for patients with symptomatic aortic stenosis and could result in higher mortality rates due to treatment delays. In this clinical case series, 3 patients underwent ambulatory transcatheter aortic valve replacement (TAVR) thanks to patient and entourage willingness, careful patient selection (including a history of permanent pacemaker placement), and a minimalist procedural approach. No complications occurred during the 30-day follow-up. Performing amb ...[more]

PMID: 32864601

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Project description:Coronavirus disease 2019 (COVID-19) has hampered health care delivery globally. We evaluated the feasibility, outcomes, and safety of telehepatology in delivering quality care amid the pandemic. A telemedicine setup using smartphones by hepatologists was organized at our tertiary-care center after pilot testing. Consecutive patients availing telehepatology services were recruited between March and July 2020. An adapted model for assessment of telemedicine was used after validity and reliability testing, to evaluate services 7-21 days after index teleconsultation. Of the 1,419 registrations, 1,281 (90.3%) consultations were completed. From 245 randomly surveyed patients, 210 (85.7%) responded (age [years, interquartile range]: 46 [35-56]; 32.3% females). Seventy percent of patients belonged to the middle or lower socio-economic class, whereas 61% were from rural areas. Modes of teleconsultation were audio (54.3%) or hybrid video call (45.7%). Teleconsultation alone was deemed suitable in 88.6% of patients. Diagnosis and compliance rates were 94% and 82.4%, respectively. Patients' convenience rate, satisfaction rate, improvement rate, success rate, and net promoter scores were 99.0%, 85.2%, 49.5%, 46.2% and 70, respectively. Physical and mental quality of life improved in 67.1% and 82.8% of patients, respectively, following index teleconsultation. Person-hours and money spent by patients were significantly lower with teleconsultation (P < 0.001); however, person-hours spent by hospital per teleconsultation were higher than in physical outpatient services (P < 0.001). Dissatisfied patients were more likely to have lower diagnosis rate, unsuitability for teleconsultation, noncompliance, poorer understanding, and uncomfortable conversation during teleconsultation. Connectivity issues (22.9%) were the most common barrier. Three patients, all of whom were advised emergency care during teleconsultation, succumbed to their illness. Conclusion: Telehepatology is a feasible and reasonably effective tool for rendering health care services using smartphones during the COVID-19 pandemic. Systematic implementation, possible integration into routine health care delivery, and formal cost-effectiveness of telehepatology services need further exploration.

Dataset Information

Ambulatory TAVR: Early Feasibility Experience During the COVID-19 Pandemic.

Publications

Ambulatory TAVR: Early Feasibility Experience During the COVID-19 Pandemic.

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