Introduction
We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period.
Methods
A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization.
Results
The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2.
Conclusion
COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.
Clinical-Surgical Correlation Braz J Cardiovasc Surg 2005; 20(1): [96][97] CLINIC DATA A male white 10-year-old patient of 34.6 kg was referred to our service. He was asymptomatic even at 6 years of age, when a heart murmur was observed and he was sent to a cardiologist. Since then, he was accompanied clinically without the use of medications. He evolved with dyspnea during exercise and another echocardiogram was taken and subsequently referred for appropriate diagnosis. The patient was in a good general state, ruddy, acyanotic and eupneic. His thorax was asymmetric with slight bulging to the left. The Ictus cordis was palpable in the 6 th intercostal space on the left hemiclavicular line. Rhythmic and normophonetic heart sounds were auscultated with a diastolic murmur at ++++/6 at the high left sternal border. The liver was located on the right costal border. Peripheral pulses of the four limbs were easily palpable. The arterial blood pressure was divergent at 110/30 mmHg.
ELECTROCARDIOGRAMSinusal rhythm with a heart rate of 75 beats per minute was evidenced. The SÂP was +30º, SÂQRS was + 60º, PR interval was 0.16 seconds, QRS was 0.08 s and QTc was 0.42 s. There was no evidence of left ventricular systolic or diastolic overload.
RADIOGRAMThe radiogram identified visceral situs solitus in levocardia. The cardiac area was at the upper limit and the cardiothoracic index was 0.51 with a slight predominance of the left ventricle. The lungs showed no alterations.
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