key: cord-0753863-xhzanzti
authors: Cosín-Sales, Juan; Barrios, Vivencio; Escobar, Carlos; Gámez, José M.
title: Telemedicine for patients with valvular heart disease or aortic disease in the era of COVID-19. Response
date: 2021-01-13
journal: Rev Esp Cardiol (Engl Ed)
DOI: 10.1016/j.rec.2020.11.013
sha: 9847457592deaa36ffe6ce1c466d380f08df59fd
doc_id: 753863
cord_uid: xhzanzti

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Telemedicine for patients with valvular heart disease or aortic disease in the era of La consulta telemática para el paciente con valvulopatı´as o enfermedad aórtica en tiempos de la To the Editor, We appreciate the letter by Gonzá lez Gó mez et al. regarding the consensus document of the Spanish Society of Cardiology on telemedicine consultation for clinical cardiologists in the era of COVID-19 1 because it marvelously complements the information provided in the consensus document, which is focused on ischemic heart disease, heart failure, and arrhythmia. Although the followup of patients with valvular heart disease and aortic disease is hugely important for clinical cardiologists, we were unable to address these conditions due to issues related to document length.

Interestingly, the authors use the same format as the consensus document, reviewing the information to be covered with patients in the telemedicine consultation and discussing which patients would require a face-to-face consultation and which can be followed up in primary care.

The authors recommend a one-time consultation with echocardiography for the follow-up of these patients. Although we believe this to be the most appropriate approach, these patients often require additional tests to complete their assessment, such as transesophageal echocardiography, computed tomography, cardiac magnetic resonance imaging, and cardiac catheterization. We believe that telemedicine consultations can also be highly useful for informing patients of the main results of these tests.

A debatable aspect would be the telematic (or face-to-face) follow-up in cardiology of patients with a mechanical or biological prosthesis, particularly when more than 1 year has passed after implantation and the patients have been stable. Such patients could perhaps be included in the group of patients for priority follow-up in primary care with the support of cardiology if new symptoms or suspected possible complications develop so that they undergo echocardiography.

Finally, an issue not considered by the authors because it is not the main topic of the letter is the modality of the procedures for the treatment of valvular heart diseases, given that the current pandemic situation would be another reason to prioritize percutaneous procedures (transcatheter aortic valve implantation, MitraClip), whenever indicated, because they can reduce the length of hospital stay (and thus also the risk of infection) and the need for admission to intensive care units. 2 Juan Cosín-Sales, a Vivencio Barrios, b 

La consulta telemá tica para el cardió logo clínico en tiempos de la COVID-19: presente y futuro, Documento de consenso de la Sociedad Españ ola de Cardiología

Intervencionismo percutá neo cardioló gico y cirugía cardiaca: el paciente en el centro de los procesos, Documento de posicionamiento de la Sociedad Españ ola de Cardiología

Telemedicine for patients with valvular heart disease or aortic disease in the era of COVID-19. Response