Outpatient management of heart valve disease following the COVID-19 pandemic: implications for present and future care.
Identifieur interne : 001912 ( Main/Corpus ); précédent : 001911; suivant : 001913Outpatient management of heart valve disease following the COVID-19 pandemic: implications for present and future care.
Auteurs : Benoy Nalin Shah ; Dominik Schlosshan ; Hannah Zelie Ruth Mcconkey ; Mamta Heena Buch ; Andrew John Marshall ; Neil Cartwright ; Laura Elizabeth Dobson ; Christopher Allen ; Brian Campbell ; Patricia Khan ; Peter John Savill ; Norman Paul Briffa ; John Boyd ChambersSource :
- Heart (British Cardiac Society) [ 1468-201X ] ; 2020.
English descriptors
- KwdEn :
- Ambulatory Care (trends), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (epidemiology), Coronavirus Infections (prevention & control), Heart Valve Diseases (epidemiology), Heart Valve Diseases (therapy), Humans (MeSH), Models, Organizational (MeSH), Organizational Innovation (MeSH), Outpatients (MeSH), Pandemics (prevention & control), Pneumonia, Viral (epidemiology), Pneumonia, Viral (prevention & control), SARS-CoV-2 (MeSH), Triage (methods), Triage (organization & administration).
- MESH :
- epidemiology : Coronavirus Infections, Heart Valve Diseases, Pneumonia, Viral.
- methods : Triage.
- organization & administration : Triage.
- prevention & control : Coronavirus Infections, Pandemics, Pneumonia, Viral.
- therapy : Heart Valve Diseases.
- trends : Ambulatory Care.
- Betacoronavirus, COVID-19, Humans, Models, Organizational, Organizational Innovation, Outpatients, SARS-CoV-2.
Abstract
The established processes for ensuring safe outpatient surveillance of patients with known heart valve disease (HVD), echocardiography for patients referred with new murmurs and timely delivery of surgical or transcatheter treatment for patients with severe disease have all been significantly impacted by the novel coronavirus pandemic. This has created a large backlog of work and upstaging of disease with consequent increases in risk and cost of treatment and potential for worse long-term outcomes. As countries emerge from lockdown but with COVID-19 endemic in society, precautions remain that restrict 'normal' practice. In this article, we propose a methodology for restructuring services for patients with HVD and provide recommendations pertaining to frequency of follow-up and use of echocardiography at present. It will be almost impossible to practice exactly as we did prior to the pandemic; thus, it is essential to prioritise patients with the greatest clinical need, such as those with symptomatic severe HVD. Local procedural waiting times will need to be considered, in addition to usual clinical characteristics in determining whether patients requiring intervention would be better suited having surgical or transcatheter treatment. We present guidance on the identification of stable patients with HVD that could have follow-up deferred safely and suggest certain patients that could be discharged from follow-up if waiting lists are triaged with appropriate clinical input. Finally, we propose that novel models of working enforced by the pandemic-such as increased use of virtual clinics-should be further developed and evaluated.
DOI: 10.1136/heartjnl-2020-317600
PubMed: 32868279
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Saint Thomas' NHS Foundation Trust, London, London, UK.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32868279</idno><idno type="pmid">32868279</idno><idno type="doi">10.1136/heartjnl-2020-317600</idno><idno type="wicri:Area/Main/Corpus">001912</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001912</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Outpatient management of heart valve disease following the COVID-19 pandemic: implications for present and future care.</title><author><name sortKey="Shah, Benoy Nalin" sort="Shah, Benoy Nalin" uniqKey="Shah B" first="Benoy Nalin" last="Shah">Benoy Nalin Shah</name><affiliation><nlm:affiliation>Cardiology, Wessex Cardiothoracic Centre, University Hospital Southampton, Southampton, UK benoy.shah@uhs.nhs.uk.</nlm:affiliation></affiliation></author><author><name sortKey="Schlosshan, Dominik" sort="Schlosshan, Dominik" uniqKey="Schlosshan D" first="Dominik" last="Schlosshan">Dominik Schlosshan</name><affiliation><nlm:affiliation>Cardiology, Leeds General Infirmary, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mcconkey, Hannah Zelie Ruth" sort="Mcconkey, Hannah Zelie Ruth" uniqKey="Mcconkey H" first="Hannah Zelie Ruth" last="Mcconkey">Hannah Zelie Ruth Mcconkey</name><affiliation><nlm:affiliation>Cardiology, Royal Berkshire Hospital, Reading, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Buch, Mamta Heena" sort="Buch, Mamta Heena" uniqKey="Buch M" first="Mamta Heena" last="Buch">Mamta Heena Buch</name><affiliation><nlm:affiliation>Cardiology, University Hospital of South Manchester NHS Foundation Trust, Manchester, Greater Manchester, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Marshall, Andrew John" sort="Marshall, Andrew John" uniqKey="Marshall A" first="Andrew John" last="Marshall">Andrew John Marshall</name><affiliation><nlm:affiliation>Cardiology, East Sussex Healthcare NHS Trust, Eastbourne, East Sussex, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Cartwright, Neil" sort="Cartwright, Neil" uniqKey="Cartwright N" first="Neil" last="Cartwright">Neil Cartwright</name><affiliation><nlm:affiliation>Cardiac Surgery, Northern General Hospital, Sheffield, Sheffield, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Dobson, Laura Elizabeth" sort="Dobson, Laura Elizabeth" uniqKey="Dobson L" first="Laura Elizabeth" last="Dobson">Laura Elizabeth Dobson</name><affiliation><nlm:affiliation>Cardiology, University Hospital of South Manchester NHS Foundation Trust, Manchester, Greater Manchester, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Allen, Christopher" sort="Allen, Christopher" uniqKey="Allen C" first="Christopher" last="Allen">Christopher Allen</name><affiliation><nlm:affiliation>Guy's & St Thomas' Hospital, Kings College, Rayne Institute, London, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Campbell, Brian" sort="Campbell, Brian" uniqKey="Campbell B" first="Brian" last="Campbell">Brian Campbell</name><affiliation><nlm:affiliation>Guy's and Saint Thomas' NHS Foundation Trust, London, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Khan, Patricia" sort="Khan, Patricia" uniqKey="Khan P" first="Patricia" last="Khan">Patricia Khan</name><affiliation><nlm:affiliation>British Heart Valve Society, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Savill, Peter John" sort="Savill, Peter John" uniqKey="Savill P" first="Peter John" last="Savill">Peter John Savill</name><affiliation><nlm:affiliation>Cardiology, Wessex Cardiothoracic Centre, University Hospital Southampton, Southampton, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Briffa, Norman Paul" sort="Briffa, Norman Paul" uniqKey="Briffa N" first="Norman Paul" last="Briffa">Norman Paul Briffa</name><affiliation><nlm:affiliation>Cardiac Surgery, Northern General Hospital, Sheffield, Sheffield, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Chambers, John Boyd" sort="Chambers, John Boyd" uniqKey="Chambers J" first="John Boyd" last="Chambers">John Boyd Chambers</name><affiliation><nlm:affiliation>Guy's and Saint Thomas' NHS Foundation Trust, London, London, UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Heart (British Cardiac Society)</title><idno type="eISSN">1468-201X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ambulatory Care (trends)</term><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (prevention & control)</term><term>Heart Valve Diseases (epidemiology)</term><term>Heart Valve Diseases (therapy)</term><term>Humans (MeSH)</term><term>Models, Organizational (MeSH)</term><term>Organizational Innovation (MeSH)</term><term>Outpatients (MeSH)</term><term>Pandemics (prevention & control)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (prevention & control)</term><term>SARS-CoV-2 (MeSH)</term><term>Triage (methods)</term><term>Triage (organization & administration)</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Heart Valve Diseases</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Triage</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Triage</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Coronavirus Infections</term><term>Pandemics</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Heart Valve Diseases</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Ambulatory Care</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>COVID-19</term><term>Humans</term><term>Models, Organizational</term><term>Organizational Innovation</term><term>Outpatients</term><term>SARS-CoV-2</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The established processes for ensuring safe outpatient surveillance of patients with known heart valve disease (HVD), echocardiography for patients referred with new murmurs and timely delivery of surgical or transcatheter treatment for patients with severe disease have all been significantly impacted by the novel coronavirus pandemic. This has created a large backlog of work and upstaging of disease with consequent increases in risk and cost of treatment and potential for worse long-term outcomes. As countries emerge from lockdown but with COVID-19 endemic in society, precautions remain that restrict 'normal' practice. In this article, we propose a methodology for restructuring services for patients with HVD and provide recommendations pertaining to frequency of follow-up and use of echocardiography at present. It will be almost impossible to practice exactly as we did prior to the pandemic; thus, it is essential to prioritise patients with the greatest clinical need, such as those with symptomatic severe HVD. Local procedural waiting times will need to be considered, in addition to usual clinical characteristics in determining whether patients requiring intervention would be better suited having surgical or transcatheter treatment. We present guidance on the identification of stable patients with HVD that could have follow-up deferred safely and suggest certain patients that could be discharged from follow-up if waiting lists are triaged with appropriate clinical input. Finally, we propose that novel models of working enforced by the pandemic-such as increased use of virtual clinics-should be further developed and evaluated.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32868279</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>05</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>18</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-201X</ISSN><JournalIssue CitedMedium="Internet"><Volume>106</Volume><Issue>20</Issue><PubDate><Year>2020</Year><Month>10</Month></PubDate></JournalIssue><Title>Heart (British Cardiac Society)</Title><ISOAbbreviation>Heart</ISOAbbreviation></Journal><ArticleTitle>Outpatient management of heart valve disease following the COVID-19 pandemic: implications for present and future care.</ArticleTitle><Pagination><MedlinePgn>1549-1554</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/heartjnl-2020-317600</ELocationID><Abstract><AbstractText>The established processes for ensuring safe outpatient surveillance of patients with known heart valve disease (HVD), echocardiography for patients referred with new murmurs and timely delivery of surgical or transcatheter treatment for patients with severe disease have all been significantly impacted by the novel coronavirus pandemic. This has created a large backlog of work and upstaging of disease with consequent increases in risk and cost of treatment and potential for worse long-term outcomes. As countries emerge from lockdown but with COVID-19 endemic in society, precautions remain that restrict 'normal' practice. In this article, we propose a methodology for restructuring services for patients with HVD and provide recommendations pertaining to frequency of follow-up and use of echocardiography at present. It will be almost impossible to practice exactly as we did prior to the pandemic; thus, it is essential to prioritise patients with the greatest clinical need, such as those with symptomatic severe HVD. Local procedural waiting times will need to be considered, in addition to usual clinical characteristics in determining whether patients requiring intervention would be better suited having surgical or transcatheter treatment. We present guidance on the identification of stable patients with HVD that could have follow-up deferred safely and suggest certain patients that could be discharged from follow-up if waiting lists are triaged with appropriate clinical input. Finally, we propose that novel models of working enforced by the pandemic-such as increased use of virtual clinics-should be further developed and evaluated.</AbstractText><CopyrightInformation>© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Shah</LastName><ForeName>Benoy Nalin</ForeName><Initials>BN</Initials><Identifier Source="ORCID">0000-0001-9681-7311</Identifier><AffiliationInfo><Affiliation>Cardiology, Wessex Cardiothoracic Centre, University Hospital Southampton, Southampton, UK benoy.shah@uhs.nhs.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schlosshan</LastName><ForeName>Dominik</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Cardiology, Leeds General Infirmary, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McConkey</LastName><ForeName>Hannah Zelie Ruth</ForeName><Initials>HZR</Initials><Identifier Source="ORCID">0000-0003-1370-5117</Identifier><AffiliationInfo><Affiliation>Cardiology, Royal Berkshire Hospital, Reading, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Buch</LastName><ForeName>Mamta Heena</ForeName><Initials>MH</Initials><AffiliationInfo><Affiliation>Cardiology, University Hospital of South Manchester NHS Foundation Trust, Manchester, Greater Manchester, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marshall</LastName><ForeName>Andrew John</ForeName><Initials>AJ</Initials><AffiliationInfo><Affiliation>Cardiology, East Sussex Healthcare NHS Trust, Eastbourne, East Sussex, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cartwright</LastName><ForeName>Neil</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Cardiac Surgery, Northern General Hospital, Sheffield, Sheffield, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dobson</LastName><ForeName>Laura Elizabeth</ForeName><Initials>LE</Initials><AffiliationInfo><Affiliation>Cardiology, University Hospital of South Manchester NHS Foundation Trust, Manchester, Greater Manchester, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Allen</LastName><ForeName>Christopher</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Guy's & St Thomas' Hospital, Kings College, Rayne Institute, London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Campbell</LastName><ForeName>Brian</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Guy's and Saint Thomas' NHS Foundation Trust, London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khan</LastName><ForeName>Patricia</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>British Heart Valve Society, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Savill</LastName><ForeName>Peter John</ForeName><Initials>PJ</Initials><AffiliationInfo><Affiliation>Cardiology, Wessex Cardiothoracic Centre, University Hospital Southampton, Southampton, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Briffa</LastName><ForeName>Norman Paul</ForeName><Initials>NP</Initials><Identifier Source="ORCID">0000-0002-9060-6131</Identifier><AffiliationInfo><Affiliation>Cardiac Surgery, Northern General Hospital, Sheffield, Sheffield, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chambers</LastName><ForeName>John Boyd</ForeName><Initials>JB</Initials><Identifier Source="ORCID">0000-0002-7169-3786</Identifier><AffiliationInfo><Affiliation>Guy's and Saint Thomas' NHS Foundation Trust, London, London, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Heart</MedlineTA><NlmUniqueID>9602087</NlmUniqueID><ISSNLinking>1355-6037</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000553" MajorTopicYN="N">Ambulatory Care</DescriptorName><QualifierName UI="Q000639" MajorTopicYN="Y">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="Y">Coronavirus Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006349" MajorTopicYN="Y">Heart Valve Diseases</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017146" MajorTopicYN="N">Models, Organizational</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009936" MajorTopicYN="N">Organizational Innovation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010045" MajorTopicYN="N">Outpatients</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="Y">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014218" MajorTopicYN="Y">Triage</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">echocardiography</Keyword><Keyword MajorTopicYN="Y">valvular heart disease</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>06</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>07</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32868279</ArticleId><ArticleId IdType="pii">heartjnl-2020-317600</ArticleId><ArticleId IdType="doi">10.1136/heartjnl-2020-317600</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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