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Cardiothoracic Surgery in the Midst of a Pandemic: Operative Outcomes and Maintaining a Coronavirus Disease 2019 (COVID-19)-free Environment

Overview
Journal JTCVS Open
Specialty Cardiology & Vascular Diseases
Date 2021 Jun 26
PMID 34173548
Citations 2
Authors
Damian Balmforth
Martin T Yates
Kelvin Lau
Azhar Hussain
Ana Lopez-Marco
Stephen Edmondson
Aung Oo
Rakesh Uppal
Affiliations
Soon will be listed here.
Abstract

Objective: In the United Kingdom, the coronavirus disease 2019 (COVID-19) pandemic has led to the cessation of elective surgery. However, there remains a need to provide urgent and emergency cardiac and thoracic surgery as well as to continue time-critical thoracic cancer surgery. This study describes our early experience of implementing a protocol to safely deliver major cardiac and thoracic surgery in the midst of the pandemic.

Methods: Data on all patients undergoing cardiothoracic surgery at a single tertiary referral center in London were prospectively collated during the first 7 weeks of lockdown in the United Kingdom. A comprehensive protocol was implemented to maintain a COVID-19-free environment including the preoperative screening of all patients, the use of full personal protective equipment in areas with aerosol-generating procedures, and separate treatment pathways for patients with and without the virus.

Results: A total of 156 patients underwent major cardiac and thoracic surgery over the study period. Operative mortality was 9% in the cardiac patients and 1.4% in thoracic patients. The preoperative COVID-19 protocol implemented resulted in 18 patients testing positive for COVID-19 infection and 13 patients having their surgery delayed. No patients who were negative for COVID-19 infection on preoperative screening tested positive postoperatively. However, 1 thoracic patient tested positive on intraoperative bronchoalveolar lavage.

Conclusions: Our early experience demonstrates that it is possible to perform major cardiac and thoracic surgery with low operative mortality and zero development of postoperative COVID-19 infection.

Citing Articles

Commentary: Cardiothoracic surgery and COVID: Must we coexist?.

Weir W, Schoel L, Ailawadi G JTCVS Open. 2021; 5:191-192.

PMID: 34173557 PMC: 7836547. DOI: 10.1016/j.xjon.2020.11.003.

Commentary: Can we do better during a potential second wave of coronavirus disease 2019 (COVID-19)?.

Engelman D, Chatterjee S JTCVS Open. 2021; 4:115-116.

PMID: 34173549 PMC: 7605862. DOI: 10.1016/j.xjon.2020.10.008.

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