Successful Coronary Artery Bypass Operation in a SARS-COV-2 Infected
Patient with Acute Coronary Syndrome
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic caused by the severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is overwhelming
healthcare resources and infrastructure worldwide. Cardiac surgical
operating capacity during the COVID-19 pandemic is dramatically lower
due to postponement or cancellation of elective or semi-urgent
procedures. Earlier reports have demonstrated complicated post-operative
courses and high fatality rates in patients undergoing emergent
cardiothoracic surgery who were diagnosed post-operatively with
COVID-19. These reports raise the possibility that active COVID-19 might
precipitate a catastrophic pathophysiogical response to infection in the
post-operative period and lead to unfavorable surgical outcomes. Hence,
it is imperative to screen patients with SARS-CoV-2 infection prior to
surgery and to carefully monitor them in the post-operative period to
identify any early signs of active COVID-19. In this report, we present
the successful outcome of coronary artery bypass grafting (CABG)
operation in a patient with asymptomatic SARS-CoV-2 infection presenting
with an acute coronary syndrome and requiring urgent surgical
intervention. We employed a meticulous strategy to identify subclinical
COVID-19 disease, and after confirming the absence of active disease,
proceeded with the CABG operation. The patient outcome was successful
with the absence of any overt COVID-19 manifestations in the
post-operative period.