Cardiac Surgery Conduct during COVID-19 PandemicFunding None.
Background Health care is seriously affected by the coronavirus disease 2019 (COVID-19) pandemic with alarming effects upon conduct of cardiac surgery. The initial resource conservation strategy has to modify for handling the surging case load due to deference of routine care in the face of pandemic.
Methods The cardiac surgical practice during the lockdown period (from 25th march till 25th June) at a tertiary care centre was observed. The cardiac diagnosis of the ones operated, conduct algorithm, and working policy were analyzed. Descriptive statistics was applied to calculate the percentages of different case subsets in both adult and pediatric groups.
Results A total of 93 cardiac patients were consecutively operated during the 3 months’ period in two cardiac theatres of a total eight dedicated and were rotated cyclically. A total of 37 (39.78%) adult cardiac surgeries were performed out of 93 cases, with coronary artery bypass grafting (11.83%: 11/93) and valvular heart diseases (11.83%: 11/93) constituting the majority. Pediatric cardiac surgeries constituted 56 cases (60.21%) which comprised of arterial switch operation (19.35%), total anomalous pulmonary venous connection (8.60%), and Blalock Taussig shunts (7.53%) predominantly. There was no COVID-19-related mortality and none of the health-care workers developed COVID-19 in the entire study period.
Conclusions The initial phase of resource conservation has undermined the routine cardiac surgical practice. The study showed that strict adherence to management algorithm is necessary for persisting smooth continuation of cardiac surgical practice with provision of optimum critical care. The strategic comeback against COVID-19 would urge institutional development of protocols to aid the post-surge period.
03 November 2020 (online)
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- 1 Worldometer. COVID-19 coronavirus pandemic. Available from: https://www.worldometers.info/. Accessed July 20, 2020
- 2 Coronavirus in India: Modi Orders Total Lockdown of 21 Days - The New York Times [Internet]. [cited 2020 Jun 29]. Available from: https://www.nytimes.com/2020/03/24/world/asia/india-coronavirus-lockdown.html. Accessed Aug 31, 2020
- 3 The top 10 causes of death. [cited 2020 Jun 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. Accessed Aug 31, 2020
- 4 Bonalumi G, di Mauro M, Garatti A, Barili F, Gerosa G, Parolari A. Italian Society for Cardiac Surgery Task Force on COVID-19 Pandemic. The COVID-19 outbreak and its impact on hospitals in Italy: the model of cardiac surgery. Eur J Cardiothorac Surg 2020; 57 (06) 1025-1028
- 5 Centers for Medicare & Medicaid Services. Non-emergent, elective medical services, and treatment recommendations. Available from: https://www.cms.gov/files/document/31820-cms-adult-elective-surgery-and-procedures-recommendations.pdf. Accessed April 21, 2020
- 6 Malaisrie SC, McDonald E, Kruse J. et al. Mortality while waiting for aortic valve replacement. Ann Thorac Surg 2014; 98 (05) 1564-1570, discussion 1570–1571
- 7 Head SJ, da Costa BR, Beumer B. et al. Adverse events while awaiting myocardial revascularization: a systematic review and meta-analysis. Eur J Cardiothorac Surg 2017; 52 (02) 206-217
- 8 Hassan A, Arora RC, Lother SA. et al. of the Canadian Society of Cardiac Surgeons. Ramping up the delivery of cardiac surgery during the covid-19 pandemic: a guidance statement from the Canadian Society of Cardiac Surgeons. Can J Cardiol 2020; 36 (07) 1139-1143
- 9 Stephens EH, Dearani JA, Guleserian KJ. et al. COVID-19: crisis management in congenital heart surgery. Ann Thorac Surg 2020; 110 (02) 701-706
- 10 Haft JW, Atluri P, Ailawadi G. et al. Society of Thoracic Surgeons COVID-19 Task Force and the Workforce for Adult Cardiac and Vascular Surgery. Adult cardiac surgery during the COVID-19 pandemic: a tiered patient triage guidance statement. Ann Thorac Surg 2020; 110 (02) 697-700