Cardiothoracic Surgery During the Covid-19 Pandemic: Perioperative care,
safety and surgical results,
Abstract
ABSTRACT Background: COVID-19 was declared a pandemic by the World
Health Organization (WHO) on March 11st, 2020. Responses to this crisis
integrated resource allocation for the increased amount of infected
patients, while maintaining an adequate response to other severe and
life-threatening diseases. Though cardiothoracic patients are at high
risk for Covid-19 severe illness, postponing surgeries would translate
in increased mortality and morbidity. We reviewed our practice during
the initial time of pandemic, with emphasis on safety protocols.
Methods: From March 11st to May 15th 2020, 148 patients underwent
surgery at the Department of Cardiothoracic Surgery of CHUSJ. The
clinical characteristics of the patients were retrospectively
registered, along with novel containment and infection prevention
measures targeting the new Corona Virus. Results: The majority of adult
cardiac patients were operated on an urgent basis. Hospital mortality
was 1.9% (n = 2 patients). Most of adult thoracic patients were
admitted from home, with a diagnosis of neoplasic disease in 60%
patients. Hospital mortality was 3.3% (1). Fifteen children underwent
cardiothoracic surgery. There was no mortality. The infection prevention
procedures applied, totally excluded the transmission of Covid-19 in the
Department. Conclusion: While guaranteeing a prompt response to
emergent, urgent and high priority cases, novel safety measures in
individual protection, patients circuits and pre-operative diagnose of
symptomatic and asymptomatic infection were adopted. The surgical
results corroborate that it was safe to undergo cardiothoracic surgery
during the initial time of Covid-19 pandemic. The new policies will be
maintained while the virus stays in the community.