June 2020 News Roundup
This month features ongoing global concerns about COVID-19, moderate conscious sedation in mitral valve repair, and more.
Cath Lab Dispatch is TCTMD’s monthly roundup of recent news tidbits from journals and medical meetings around the globe.
An American College of Cardiology/Society for Cardiovascular Angiography and Interventions position statement published simultaneously in Catheterization and Cardiovascular Interventions and JACC: Interventional Cardiology, provides a framework for helping heart teams manage the COVID-19-related triage of patients requiring structural heart disease interventions, including TAVR and mitral valve repair.
In an analysis published in the Journal of the American College of Cardiology, 44% of patients in a contemporary PCI cohort were at high risk of bleeding according to Academic Research Consortium-High Bleeding Risk (ARC-HBR) criteria. At 1 year, the rate of the primary bleeding endpoint was 9.1% in HBR patients versus 3.2% in non-HBR patients (P < 0.001).
A survey of interventional cardiologists from 18 different countries published in the Journal of the American Heart Association found that more than 80% of operators have concerns about being asked to perform PCI on a patient with suspected or confirmed COVID-19, primarily due to fear of viral transmission.
Moderate conscious sedation is safe and effective in patients undergoing transcatheter mitral valve repair, according to results from a study of over 100 patients implanted with a MitraClip device (Abbott Vascular). Reporting in the Journal of Invasive Cardiology, the researchers say compared with general anesthesia, the average duration of procedures was shorter, and costs were lower when patients were extubated in the cath lab and sent directly to the standard telemetry unit for observation.
From EuroIntervention, a survey by the European Association of Percutaneous Coronary Interventions on the impact of COVID-19 on management of STEMI found that 27% of respondents reported coronary angiography and PCI were reduced or stopped, 48% reported an increased delay in reperfusion, and 22% said fibrinolysis was administered because of logistical reasons related to the pandemic.
Having a history of cancer does not adversely affect short- or long-term mortality after TAVR, according to a systematic review published in Catheterization and Cardiovascular Interventions. Compared with patients with no prior cancer, those with a history of malignancy also were not more likely to experience higher rates of stroke, bleeding, acute kidney injury, or pacemaker implantation.
Returning to work and being reasonably recovered within 1 to 5 years of a heart transplant are predictors of a high levels of self-efficacy, with no difference between men and women, according to a Swedish study published in the European Journal of Cardiovascular Nursing.
When the Society of Vascular Surgery queried its members about their concerns for patients during the pandemic, they learned that lack of activity, stress levels, and triaging of those needing surgery topped the list.
Writing in the European Heart Journal, Canadian researchers report a case of a patient who developed a massive left ventricle pseudoaneurysm after authorities at a rural hospital refused to allow transfer to a specialized center out of concerns over COVID-19.
In patients undergoing complex TAVR, dedicated patient-specific computer simulation can accurately predict valve size as well as the severity and location of paravalvular aortic regurgitation, researchers conclude in a single-center case series published in Structural Heart.