Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic

Abstract

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Prioritizing elective cardiovascular procedures during the COVID‐19 pandemic: The cardiovascular medically necessary, time‐sensitive procedure scorecard

“…By providing a more objective and quantifiable way of assessing these factors, the CV MeNTS procedure scorecard can be incorporated into a transparent prioritization process that mitigates the moral and ethical burden of decision-makers when put in the difficult situation of having to rationalize resources during the pandemic and may minimize the possibility of conflict among healthcare providers competing for such resources.The importance of having and utilizing such prioritization tools is underscored by state executive orders that direct the efforts to resume elective procedures and require mechanisms to prioritize cases, like New Jersey's Executive Order 145 9. The guidance of various professional societies to safely reintroduce CV services during the COVID-19 pandemic10 also highlights the need to have plans in place that balance the benefits of offering treatment with the risk of exacerbating the spread of COVID-19 while ensuring reserve capacity in the event of a second surge following the values of fairness and consistency. Introducing a standardized and objective approach to any prioritization process using the CV MeNTS procedure scorecard is a step in this direction.…”

Society for Cardiovascular Magnetic Resonance (SCMR) guidance for re-activation of cardiovascular magnetic resonance practice after peak phase of the COVID-19 pandemic

“…When evaluating the appropriate timing to scale up semi-urgent and elective procedures, CMR units should consider coordinating with local and state public health and hospital system officials to review the availability of PPE for staff and patients, testing capacity, CMR facility readiness including physical distancing preparedness in reception areas, and workforce availability (including technologists, nurses, and interpreting physicians). Moreover, the needs of specific clinical services which are also re-activating should also be considered including other MRI specialties, electrophysiology, other imaging, interventional cardiology, heart failure, cardiac surgery, thoracic surgery, and vascular surgery [11]. Reactivation should proceed at a rate that appropriately balances the availability of resources with the clinical demand for CMR examinations and patient readiness.…”

“…As the first peak phase passes, semi-urgent and elective CMR examinations can begin to be scheduled. The American College of Radiology (ACR) has provided guidance on the safe resumption of non-urgent diagnostic imaging, while a consensus document from multiple North American cardiovascular societies has outlined procedures for safe re-introduction of cardiovascular services [11,12]. According to the ESCR, cardiac imaging programs should be firstly reopened to patients with "subacute" indications that were rescheduled during the pandemic, whereas pre-operative scans may be scheduled close to the surgical procedures [7].…”

Recommendations for risk stratified use of cardiac computed tomography for congenital heart disease during the COVID-19 pandemic

“…The leaders of several North American cardiovascular professional societies recently published guidance for the reintroduction of cardiovascular services. 10 Recommendations are applicable to CHD CCT imaging and include maximizing benefits to those undergoing CCT, weighing the benefit of CCT with the risk of potential for further COVID-19 spread, and consistency in the availability of such services to patients regardless of factors that may impede their accessibility such as social class or ethnicity.…”