Abstract The coronavirus disease 2019 pandemic, caused by severe acute respiratory syndrome coronavirus‐2, represents the third human affliction attributed to the highly pathogenic coronavirus in the current century. Because of its highly contagious nature and unprecedented global spread, its aggressive clinical presentation, and the lack of effective treatment, severe acute respiratory syndrome coronavirus‐2 infection is causing the loss of thousands of lives and imparting unparalleled strain on healthcare systems around the world. In the current report, we discuss perioperative considerations for patients undergoing cardiac surgery and provide clinicians with recommendations to effectively triage and plan these procedures during the coronavirus disease 2019 outbreak. This will help reduce the risk of exposure to patients and healthcare workers and allocate resources appropriately to those in greatest need. We include an algorithm for preoperative testing for coronavirus disease 2019, personal protective equipment recommendations, and a classification system to categorize and prioritize common cardiac surgery procedures.

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A 27-year-old man was referred for elective surgical removal of a right atrial mass. He had a history of dyspnea and mild chest discomfort on exertion. Four years earlier, he had undergone neck surgery to remove a swollen lymph node; it was benign and had not recurred. Recent cardiac magnetic resonance (CMR) images showed a 2 × 2 × 2-cm right atrial mass immediately inferior to the noncoronary sinus of Valsalva. The mass had a smooth, well-defined margin and was not attached to the interatrial septum (Fig. 1). Sensing a possible change in diagnosis, we performed intraoperative transesophageal echocardiography (TEE) via probe before making a median sternotomy. Compared with the preoperative CMR findings, TEE showed a sinus of Valsalva aneurysm (SVA) arising from the noncoronary cusp (Fig. 2), and no fistula between the aneurysmal sac and the cardiac chambers (Fig. 3). Aortic valve function and that of the other coronary sinuses were normal. After

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