Ramping Up the Delivery of Cardiac Surgery During the COVID-19 Pandemic: A Guidance Statement From the Canadian Society of Cardiac Surgeons

Hassan, Ansar; Arora, Rakesh C.; Lother, Sylvain; Adams, Corey; Bouchard, Denis; Cook, R.C.M.; Gunning, Derek; Lamarche, Yoan; Malas, Tarek; Moon, Michael; Ouzounian, Maral; Rao, Vivek; Rubens, Fraser D.; Tremblay, Philippe; Whitlock, Richard; Moss, Emmanuel; Légaré, Jean‐François

doi:10.1016/j.cjca.2020.04.030

Cited by 30 publications

(34 citation statements)

References 5 publications

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“…As a result, cardiac surgical programs engaged into a new reality of patient selection, prioritizing urgent cases while delaying elective procedures. Similar circumstances are reported worldwide [1,4,5,7]. Additionally, from fear of getting infected, a new phenomenon of avoiding medical care emerged, and thus, non-COVID-19 patients requiring cardiac surgery refrained from requesting help.…”

Section: Introductionsupporting

confidence: 54%

“…According to their suggestion, upon a mild reduction in services (0-30%), only symptomatic outpatients or those at greater risk for developing adverse events, should undergo surgery alongside the urgent cases. Under a > 50% reduction in services, they suggested operating on urgent cases only [4,7].…”

Section: Discussionmentioning

confidence: 99%

“…As of May 20, 2020, more than five million people worldwide were affected by the virus with about 325,000 deaths. Since the beginning of COVID-19 the world has changed drastically, and various measures have been taken in an attempt to "flatten the curve", some of them having an unprecedented effect on world health systems [4].…”

Section: Introductionmentioning

confidence: 99%

“…Virtually all medical specialties were required to significantly reduce their daily routine services. Specifically, cardiac surgeons were requested to scale down their clinical practice and adapt to a new hospital policy [4][5][6]. As a result, cardiac surgical programs engaged into a new reality of patient selection, prioritizing urgent cases while delaying elective procedures.…”

Section: Introductionmentioning

confidence: 99%

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The impact of COVID-19 pandemic on cardiac surgery in Israel

Keizman

Ram

Kachel

et al. 2020

J Cardiothorac Surg

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Background Ever since the coronavirus disease 2019 (COVID-19) has become a pandemic, worldwide efforts are being made to “flatten the curve”. Israel was amongst the first countries to impose significant restrictions. As a result, cardiac surgeons have been required to scale down their routine practice, resulting in a significant reduction in the number of cardiac surgeries. The aim of this study is to characterize the impact of COVID-19 on cardiac surgery in Israel. Methods This is a retrospective observational study performed in two cardiac surgery departments in Israel and includes all patients who underwent cardiac surgery in March and April during the years 2019 and 2020. The patient cohort was divided into two groups based on the year of operation. Analysis of the patients’ baseline characteristics, operative data, and postoperative outcome, was performed. Results The 2019 group (n = 173), and the 2020 group (n = 108) were similar regarding their baseline characteristics, previous medical history, and rates of previous revascularization interventions. However, compared to the 2019 group, patients in the 2020 group were found to be more symptomatic (NYHA class IV; 2.4% vs. 6.2%, p = 0.007). While all patients underwent similar procedures, patients in the 2020 group had significantly longer procedural time (p < 0.001). In-hospital mortality rate was found to be significantly higher in group 2020 (13% vs. 5.2%, p = 0.037). Conclusions While the number of patients undergoing cardiac surgery declined during the outbreak period, the rate of surgical mortality increased. One explanation for this might be delayed hospital arrival.

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Section: Introductionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The impact of COVID-19 pandemic on cardiac surgery in Israel

Keizman

Ram

Kachel

et al. 2020

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…Timing of surgery is divided into emergency, which must be done within 24-48 h of diagnosis when there are adequate resources; urgent, which should be done within 1-2 weeks when there are adequate resources; and high priority elective, which can be done > 2 weeks later when there are adequate resources, with prerequisite that timing for categories is dependent on the resources available, institutional protocols, and other pending cases. A guidance statement on the triage of cardiac surgery patients was published by the Canadian Society of Cardiac Surgeons, who categorized the triage levels into three stages based on the reduction of hospital services available [63]. The elective case triage guidelines for vascular surgery appeared on the ACS homepage on March 24, 2020 [64].…”

Section: Cardiovascular Surgerymentioning

confidence: 99%

COVID-19: clinical issues from the Japan Surgical Society

et al. 2020

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In this unprecedented COVID-19 pandemic, several key issues must be addressed to ensure safe treatment and prevent rapid spread of the virus and a consequential medical crisis. Careful evaluation of a patient's condition is crucial for deciding the triage plan, based on the status of the disease and comorbidities. As functionality of the medical care system is greatly affected by the environmental situation, the treatment may differ according to the medical and infectious disease circumstances of the institution. Importantly, all medical staff must prevent nosocomial COVID-19 by minimizing the effects of aerosol spread and developing diagnostic and surgical procedures. Polymerase chain reaction (PCR) screening for COVID-19 infection, particularly in asymptomatic patients, should be encouraged as these patients are prone to postoperative respiratory failure. In this article, the Japan Surgical Society addresses the general principles of surgical treatment in relation to COVID-19 infection and advocates preventive measures against viral transmission during this unimaginable COVID-19 pandemic.

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Impact of COVID-19 on Management Strategies for Coronary and Structural Heart Disease Interventions

et al. 2022

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Purpose of Review The COVID-19 pandemic has created unprecedented challenges globally, with significant strain on the healthcare system in the United States and worldwide. In this article, we review the impact of COVID-19 on percutaneous coronary interventions and structural heart disease practices, as well as the impact of the pandemic on related clinical research and trials. We also discuss the consensus recommendations from the scientific societies and suggest potential solutions and strategies to overcome some of these challenges. Findings With the limited resources and significant burden on the healthcare system during the pandemic, changes have evolved in practice to provide care to the highest risk patients while minimizing unnecessary exposure during elective surgical or transcatheter procedures. Summary The COVID-19 crisis has significantly impacted the management of patients with acute coronary syndromes, chronic coronary syndromes, and structural heart disease.

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Ramping Up the Delivery of Cardiac Surgery During the COVID-19 Pandemic: A Guidance Statement From the Canadian Society of Cardiac Surgeons

Cited by 30 publications

References 5 publications

The impact of COVID-19 pandemic on cardiac surgery in Israel

The impact of COVID-19 pandemic on cardiac surgery in Israel

COVID-19: clinical issues from the Japan Surgical Society

Impact of COVID-19 on Management Strategies for Coronary and Structural Heart Disease Interventions

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