Cardiac surgery in the time of the coronavirus

Abstract

The current Covid-19 pandemic is a significant global health threat. The outbreak has profoundly affected all healthcare professionals, including heart surgeons. To adapt to these exceptional circumstances, cardiac surgeons had to change their practice significantly. We herein discuss the challenges and broad implications of the Covid-19 pandemic from the perspective of the heart surgeons.

The impact of COVID‐19 pandemic on congenital heart surgery practice: An alarming change in demographics

“…5 However, being hasty in reducing pandemic measures can lead to a high second wave like that seen in the 1918 Spanish Flu pandemic. 6 Reducing the number of patients operated daily is a useful approach in terms of keeping the intensive care beds available as well as contributing to social distancing. The patients were triaged according to urgency, but elective cases such as ASD closure were also performed ( Table 2).…”

Cardiac surgery considerations and lessons learned during the COVID‐19 pandemic

“…In 2007, the STS created a task force to develop quality measures for pediatric and congenital cardiac surgery, and in 2011, the Congenital Heart Surgeons Society endorsed the STS measures 46 . Jacobs et al defined 21 quality measures, including 1 multidisciplinary rounds, 2 multidisciplinary preoperative planning conference 3 and quality assurance and improvement conference 46 . It is critical these steps are taken during this COVID‐19 pandemic.…”

“…The COVID‐19 pandemic has transformed cardiac surgical practices throughout the globe 1 . Although many elective operations were delayed, surgeons were forced to balance the ongoing need of providing urgent and emergent surgical care with the new realities of limited resources.…”

The day after tomorrow: cardiac surgery post-COVID-19.

“…Our policy as cardiac surgeons throughout this period of lock-down was to delay all elective procedures on the one hand, and to refer patients to less invasive percutaneous coronary intervention (PCI), transcatheter aortic valve replacement (TAVR) or transcatheter mitral valve replacement (TMVR) procedures on the other hand. Most cardiac surgeons limited surgery to cases such as acute aortic dissections, emergency coronary artery syndromes not amenable to PCI or time-sensitive valve surgery not amenable to TAVR or TMVR (3). With the first signs of resolution of the pandemic and the start of delivery in several European countries, a significant number of patients are expected to be treated: patients who are symptomatic but who preferred not to consult during the lockdown period and asymptomatic ones who had delayed or cancelled appointments for follow-up of their chronic diseases.…”