Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for elderly patients with symptomatic severe aortic stenosis (AS) . Left untreated, symptomatic AS is lethal with high 1-year mortality rates . The Coronavirus disease-2019 (COVID-19) pandemic urged for reallocations of resources. Dedicated COVID-19 wards and intensive care units (ICU) prioritized COVID-19 care and elective healthcare was postponed. Furthermore, cardiology societies issued statements favoring telehealth and less-invasive catheter based treatment strategies over conventional cardiac surgery to limit ICU occupation and catalyze early discharge . COVID-19 regulations delayed the diagnosis of severe AS because of higher thresholds to perform echocardiography in the outpatient clinic, postponed referrals for aortic valve replacement (AVR) and, conversely, triggered longer AVR waiting lists. In our center TAVR has transformed into a procedure under local anesthesia without default ICU monitoring, promoting early ambulation and shorter hospital stay. In this single center, observational cohort study, we evaluated changes in the clinical presentation of patients referred for transcatheter aortic valve treatment including TAVR and balloon aortic valvuloplasty (BAV) in the year before vs. during the COVID-19 outbreak in the Netherlands that started February 27th 2020.