Cardiothoracic Surgery at the Time of the Coronavirus Disease–2019 Pandemic: Lessons From the East (and From a Previous Epidemic) for Western Battlefields

Pisano, Antonio; Landoni, Giovanni; Verniero, Luigi; Zangrillo, Alberto

doi:10.1053/j.jvca.2020.04.051

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…This multicentre national survey clearly shows the unprecedented impact on cardiac surgery practice of the current COVID-19 pandemic. Excluding those few countries (such as China, Vietnam, Singapore and Canada), which faced the 2003 severe acute respiratory syndrome outbreak, most Western countries were found woefully unprepared both culturally and in terms of facilities and equipment [ 7 , 8 ]. As mentioned previously, the number of hospital beds in Italy is chronically lower than the European average and has been further reduced by healthcare cost reduction policies since 2012 [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac surgery practice during the COVID-19 outbreak: a multicentre national survey

Rubino

Santo

Mauro³

et al. 2021

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Healthcare systems worldwide have been overburdened by the coronavirus disease 2019 (COVID-19) outbreak. Accordingly, hospitals had to implement strategies to profoundly reshape both non-COVID-19 medical care and surgical activities. Knowledge about the impact of the COVID-19 pandemic on cardiac surgery practice is pivotal. The goal of the present study was to describe the changes in cardiac surgery practices during the health emergency at the national level. METHODS A 26-question web-enabled survey including all adult cardiac surgery units in Italy was conducted to assess how their clinical practice changed during the national lockdown. Data were compared to data from the corresponding period in 2019. RESULTS All but 2 centres (94.9%) adopted specific protocols to screen patients and personnel. A significant reduction in the number of dedicated cardiac intensive care unit beds (−35.4%) and operating rooms (−29.2%), along with healthcare personnel reallocation to COVID departments (nurses −15.4%, anaesthesiologists −7.7%), was noted. Overall adult cardiac surgery volumes were dramatically reduced (1734 procedures vs 3447; P < 0.001), with a significant drop in elective procedures [580 (33.4%) vs 2420 (70.2%)]. CONCLUSIONS This national survey found major changes in cardiac surgery practice as a response to the COVID-19 pandemic. This experience should lead to the development of permanent systems-based plans to face possible future pandemics. These data may effectively help policy decision-making in prioritizing healthcare resource reallocation during the ongoing pandemic and once the healthcare emergency is over.

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Section: Discussionmentioning

confidence: 99%

Cardiac surgery practice during the COVID-19 outbreak: a multicentre national survey

Rubino

Santo

Mauro³

et al. 2021

European Journal of Cardio-Thoracic Surgery

Self Cite

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“…Many cases of elective surgery have been postponed due to the current pandemic, but some elective and especially emergency cardiac surgeries cannot be delayed. Moreover, a heavy burden of mortality of cardiac surgery may be considered in patients with COVID-19 and the unavailability of information and the lack of specific guidelines for elective and emergency surgical interventions make it difficult to manage these patients, so developing a standard and safe protocol is needed [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Acute Type a Aortic Dissection in a Patient With COVID-19

Tabaghi

Akbarzadeh

2020

Future Cardiol.

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The novel coronavirus spread all over the world in 2019 and became a serious international health concern of this century. Coronavirus disease 2019 (COVID-19) had a wide range of clinical manifestations; it can cause mild-to-severe multiorgan diseases, mostly affecting the respiratory system, but cardiovascular symptoms and complications are also frequently presented in COVID-19 patients. Herein, we report a type A aortic dissection in a confirmed case of COVID-19.

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“…The spread of the pandemic has forced hospitals to reorganize their activities. Although a low percentage of patients needed a place in the intensive care unit (ICU), the widespread of the infection led to a rapid saturation of available beds and forced many departments to transform into Covid-19 care wards ( 18 , 19 ). Thoracic surgery for NSCLC has been considerably reduced in 48% of the European centers because of minimal ICU beds available and shortage of personnel that in 63% of the centers was involved in the cure of Covid-19 patients ( 11 ).…”

Section: Surgery Planningmentioning

confidence: 99%

Perspective: Did Covid-19 Change Non-small Cell Lung Cancer Surgery Approach?

et al. 2021

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The novel coronavirus (Covid-19), as of January 2021, infected more than 85 million people worldwide, causing the death of about 1,840 million. Italy had more than 2 million infected and about 75,000 deaths. Many hospitals reduced their ordinary activity by up to 80%, to leave healthcare staff, wards, and intensive care unit (ICU) beds available for the significant number of Covid-19 patients. All this resulted in a prolonged wait for hospitalization of all other patients, including those with non-small cell lung cancer (NSCLC) eligible for surgery. The majority of thoracic surgery departments changed the clinical-therapeutic path of patients, re-adapting procedures based on the needs dictated by the pandemic while not delaying the necessary treatment. The establishment of Covid-19-free hub centers allowed some elective surgery in NSCLC patients but most of the operations were delayed. The technology has partly facilitated patients' visits through telemedicine when security protocols have prevented face-to-face assessments. Multidisciplinary consultations had to deal also with the priority of the NSCLC cases discussed. Interpretation of radiologic exams had to take into account the differential diagnosis with Covid-19 infection. All the knowledge and experience of the past months reveal that the Covid-19 pandemic has not substantially changed the indications and type of surgical treatment in NSCLC. However, the diagnostic process has become more complex, requiring rigorous planning, thus changing the approach with the patients.

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Cardiothoracic Surgery at the Time of the Coronavirus Disease–2019 Pandemic: Lessons From the East (and From a Previous Epidemic) for Western Battlefields

Cited by 5 publications

References 11 publications

Cardiac surgery practice during the COVID-19 outbreak: a multicentre national survey

Cardiac surgery practice during the COVID-19 outbreak: a multicentre national survey

Acute Type a Aortic Dissection in a Patient With COVID-19

Perspective: Did Covid-19 Change Non-small Cell Lung Cancer Surgery Approach?

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