Surgical correction of isolated adult TAPVC can be carried out safely with acceptable long-term outcome. Postoperative tricuspid insufficiency and cardiac arrhythmias may have a negative long-term impact, which should be evaluated preoperatively and managed individually during surgery.
Objective
This study aimed to provide an insight into the impact of early outbreak of the novel coronavirus disease 2019 (COVID-19) on the care management for patients with congenital heart disease.
Methods
This study respectively enrolled a cohort of surgical patients (patients undergoing surgery in 2018 [group I], 2019[group II], and 2020 [group III]) and a cohort of follow-up patients (patients having follow-up in 2017 [group A], 2018 [group B] and 2019 [group C]) from 13 children hospitals.
Results
During the COVID-19 era, there was a significant decrease in total surgical volume and a change in case mix in terms of an increase in the proportion of emergency operations. Decrease in migration scale index was correlated to the decrease in both surgical volume (r=0.64, p=0.02) and outpatient visit volume (r=0.61, p=0.03). There was a significantly higher proportion of patients who had follow-up through the internet or phone in group C (26.4% vs. 9.6% in group B and 8.9% in group A; p< 0.0001). There was no statistical difference in death or rehospitalization among the 3 follow-up groups (p=0.49). There was higher parents’ anxiety score (p < 0.0001) and more utilization of telemedicine (p = 0.004) in group C comparing to group A and B.
Conclusion
The COVID-19 pandemic has resulted in a considerable decrease in total surgical volume and a change of case mix, which seems to be related to the strict traffic ban. Follow-up through the online medical service appears to be an effective alternative to the conventional method.
The palliative arterial switch operation significantly improved the quality of life and possibly life expectancy in patients with transposition of the great arteries, ventricular septal defect, and severe pulmonary vascular obstructive disease. Postoperative pulmonary vascular resistance might be reversible in some patients. Closing the ventricular septal defect with a fenestrated patch, which can be easily closed nonsurgically later on, might contribute to a safer postoperative recovery.
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