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Vol. 74. Issue 4.
Pages 362-363 (April 2021)
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Vol. 74. Issue 4.
Pages 362-363 (April 2021)
Letter to the Editor
DOI: 10.1016/j.rec.2020.11.013
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Telemedicine for patients with valvular heart disease or aortic disease in the era of COVID-19. Response
La consulta telemática para el paciente con valvulopatías o enfermedad aórtica en tiempos de la COVID-19. Respuesta
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Juan Cosín-Salesa, Vivencio Barriosb,
Corresponding author
vivenciobarrios@gmail.com

Corresponding author:
, Carlos Escobarc, José M. Gámezd
a Servicio de Cardiología, Hospital Arnau de Vilanova, Valencia, Spain
b Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
c Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
d Servicio de Cardiología, Hospital Universitario Son Llàtzer, Palma de Mallorca, Balearic Islands, Spain
Related content
Rev Esp Cardiol. 2021;74:361-210.1016/j.rec.2020.11.009
Ariana González Gómez, Irene Méndez Santos, Vanessa Moñivas Palomero, Francisco Calvo Iglesias
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To the Editor,

We appreciate the letter by González Gómez et al. regarding the consensus document of the Spanish Society of Cardiology on telemedicine consultation for clinical cardiologists in the era of COVID-191 because it marvelously complements the information provided in the consensus document, which is focused on ischemic heart disease, heart failure, and arrhythmia. Although the follow-up 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

References
[1]
V. Barrios, J. Cosín-Sales, M. Bravo, et al.
La consulta telemática para el cardiólogo clínico en tiempos de la COVID-19: presente y futuro, Documento de consenso de la Sociedad Española de Cardiología.
Rev Esp Cardiol., 73 (2020), pp. 910-918
[2]
A. Cequier, A. Pérez de Prado, R. Moreno, et al.
Intervencionismo percutáneo cardiológico y cirugía cardiaca: el paciente en el centro de los procesos, Documento de posicionamiento de la Sociedad Española de Cardiología.
Rev Esp Cardiol., 72 (2019), pp. 658-663
Copyright © 2020. Sociedad Española de Cardiología
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