COVID-19 and Cardiovascular Surgery. Do We Know What We Are Dealing With?

Impact of the COVID-19 Outbreak on Coronary Artery Bypass Grafting in Brazil

“…23 In the midst of this scenario of scarcity of vacancies, there were even greater complications due to the lack of essential materials for CABG, such as equipment for extracorporeal circulation and cannulas. 24 In addition to these scarcity factors that prevented elective cardiac surgeries from being performed, the suspension of surgeries in patients infected with SARS-CoV-2 also became a factor to consider. It was observed that the risk of death or severe postoperative complications in patients who tested positive for COVID-19 with reverse transcription-polymerase chain reaction (RT-PCR) decreased over time.…”

“…18 However, the individual risk of each patient must be considered to predict the best prognosis, establishing a balance between potential risks and time of positive RT-PCR. 24 In this new landscape, it is also necessary to consider that patients undergoing CABG surgery are at risk of exposure to the virus, given that the surgery is highly invasive, generates aerosols, potentially requires prolonged stay in the intensive care units, and involves intense use of healthcare resources. Therefore, several recommendations and guidelines have emerged on how to conserve resources and screen patients who require more urgent and efficient care.…”

“…21 However, the number of patients waiting for surgery tripled during this dark period, and, although there have already been some consequences, surgery cancellations will continue to affect patients for years to come. 24,27 It is still unknown what the actual outcome of all this will be, and recovery will depend on multilateral and collaborative results to ensure patient safety and health. 26,27…”

The impact of the coronavirus pandemic on patients hospitalized due to acute coronary syndrome

“…The number of patient referrals for CABG during initial hospitalization remained unchanged, but the number of scheduled surgical procedures, planned after being discharged from the hospital, decreased. In some reports, an 80 percent reduction of CABG was observed, which was correlated with an increase in local incidence of COVID-19 [ 11 , 13 , 17 , 18 , 20 , 39 ].…”

“…As discussed before, the focus of healthcare has been shifted towards aiding COVID-19 patients – which led to a critical reduction of both planned and actually performed surgical interventions. The effect will probably be long-lasting and will have a great impact on society in general (which may be associated not only with increased treatment costs, but also prolonged exclusion of patients with delayed procedures from employment or the healthcare system having less funds to perform its tasks) [ 18 ].…”