Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic: From the North American Society Leadership

Abstract

Edwards Lifesciences and Abbott Vascular; and has served as a consultant to Edwards Lifesciences, Medtronic, Abbott Vascular, and Boston Scientific. Dr. Mahmud has served as a consultant for Abiomed, Medtronic, and Boston Scientific; has received clinical trial support from Corindus; has served as Chairman of the Data Safety Monitoring Board for CAD III and CAD IV studies sponsored by Shockwave, Inc.; and has served as Chairman of the Data Safety Monitoring Board for the EluNIR-HBR Study sponsored by Medinol. Dr. Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.

Multimodality Cardiovascular Imaging in the Midst of the COVID-19 Pandemic

“…The selective use of CT has been shown to be valuable in the acute phase of COVID-19 and will likely serve an important role for new symptoms of possible angina during the convalescent or chronic phase of their illness (15,16). As institutions begin to reintroduce full cardiovascular imaging services, CT will continue to allow for safe and rapid diagnosis of conditions ranging from CAD to valvular heart disease (8,15,18,19,21) (Table 3). Table 3).…”

Cardiac Surgery-Enhanced Recovery Programs Modified for COVID-19: Key Steps to Preserve Resources, Manage Caseload Backlog, and Improve Patient Outcomes

“…The second is to identify the best timing for ERP implementation, assess local and regional pandemic status-current and anticipated-and review prediction models, expected surgical volume, and current guidelines for safe delivery of cardiac surgical care during COVID-19. 4,6,22,23,31 The third is to identify the strengths and weaknesses in current cardiac surgery programs. This should be done in an open, honest, objective, and dispassionate manner based on real institutional historic data.…”

“…3 The forced deferral of necessary care has resulted in a backlog of patients, leading to new potential risks of increased morbidity and mortality secondary to longer wait times. 4,5 As the acute burden of coronavirus illness subsides and cities and countries enter the recovery phase, hospitals will feel intense external and internal pressure to "catch up" on their deferred procedures while maintaining preparedness for new resurgences. 6 The results of modeling of the increased capacity required to work through the cardiac surgical backlog is daunting.…”

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

“…This reopening will be in some manner a step‐wise process as many primary care and cardiology practices have been operating on an alternate schedule for an extended period of time and some patients may be hesitant to seek attention for symptoms such as angina or dyspnea with exertion 24 . To maintain relationships with patients during the pandemic, many cardiac surgical practices have utilized telemedicine via video or phone conversations with high patient satisfaction rates 25,26 . These virtual interactions remain important to decide which patient will require conversion from an elective procedure to more urgent.…”

“…As hospital systems transition to full scale elective operations, the initial set of operations should be chosen thoughtfully, balancing clinical need with implementation of screening practices, critical care resources, and hospital‐level disease mitigation strategies 26,27 . Practices for universal precautions developed during the pandemic peak, such as aggressive hand hygiene, must continue to be adhered to aggressively.…”