Heart team consultations for patients with severe coronary artery disease or valvular heart disease in the era of the COVID-19 pandemic: a single-center experience

Szymon Jonik; Maria Boszko; Elena Sztemberg; Dominik Łepecki; Bartłomiej Grodziński; Marcin Mikusek-Pham Van; Michał Marchel; Janusz Kochman; Mariusz Kuśmierczyk; Grzegorz Opolski; Marcin Grabowski; Tomasz Mazurek

doi:10.3389/fcvm.2023.1203535

Heart team consultations for patients with severe coronary artery disease or valvular heart disease in the era of the COVID-19 pandemic: a single-center experience

Front Cardiovasc Med. 2023 Jul 19:10:1203535. doi: 10.3389/fcvm.2023.1203535. eCollection 2023.

Affiliations

¹ 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
² Department of Cardiac Surgery, Medical University of Warsaw, Warsaw, Poland.

Abstract

Introduction: The Heart Team (HT) as a group of experienced specialists is responsible for optimal decision-making for high-risk cardiac patients. The aim of this study was to investigate the impact of the COVID-19 pandemic on HT functioning.

Methods: In this retrospective, single-center study, we evaluated the cooperation of HT in terms of the frequency of meetings, the number of consulted patients, and the trends in choosing the optimal treatment strategies for complex individuals with severe coronary artery disease (CAD) or valvular heart disease (VHD) before and during the COVID-19 pandemic in Poland.

Results: From 2016 to May 2022, 301 HT meetings were held, and a total of 4,183 patients with severe CAD (2,060 patients) or severe VHD (2,123 patients) were presented. A significant decrease in the number of HT meetings and consulted patients (2019: 49 and 823 vs. 2020: 44 and 542 and 2021: 45 and 611, respectively, P < 0.001) as well as changes in treatment strategies-increase of conservative, reduction of invasive (2019: 16.7 and 51.9 patients/month vs. 2020: 20.4 and 24.8 patients/month and 2021:19.3 and 31.6 patients/month, respectively, P < 0.001)-were demonstrated with the spread of the COVID-19 pandemic. As the pandemic slowly receded, the observed changes began to return to the pre-pandemic trends.

Conclusions: The COVID-19 pandemic resulted in a decrease in the number of HT meetings and consulted patients and significant reduction of invasive procedures in favor of conservative management. Further studies should be aimed to evaluate the long-term implications of this phenomenon.

Keywords: COVID-19 pandemic; Heart Team; aortic stenosis; mitral regurgitation; multivessel coronary artery disease.