No abstract

The European Association of Cardiothoracic Anaesthesiology (EACTA) and the Society of Cardiovascular Anesthesia (SCA) aimed to create joint recommendations for the perioperative management of patients with suspected or proven SARS-CoV-2 infection undergoing cardiac surgery or invasive cardiac procedures. To produce appropriate recommendations, we combined the evidence from the literature review, re-evaluating the clinical experience of routine cardiac surgery in similar cases during the Middle East Respiratory Syndrome (MERS-CoV) outbreak and the current pandemic with suspected COVID-19 patients, and the expert opinions through broad discussions within EACTA and SCA. We took into consideration the balance between established procedures and the feasibility during the present outbreak. We represent an agreement between the European and United States practices in managing patients during the COVID-19 pandemic. The recommendations take into consideration a broad spectrum of issues with a focus on preoperative testing, safety concerns, overall approaches to general and specific aspects of preparation for anesthesia, airway management, transesophageal echocardiography, perioperative ventilation, coagulation, and hemodynamic control and postoperative care. As the COVID-19 pandemic is spreading, it will continue to represent a challenge for the worldwide anesthesiology community. To allow these recommendations to be updated as long as possible, we provided weblinks to international public and academic sources providing timely updated data. Our document should be the basis of future Task Forces to develop a more comprehensive consensus considering new evidence uncovered during the COVID-19 pandemic.