• Ann. Thorac. Surg. · Oct 2020

    Review

    The Rapid Transformation of Cardiac Surgery Practice in the Coronavirus Disease 2019 (COVID-19) Pandemic: Insights and Clinical Strategies From a Center at the Epicenter.

    • Isaac George, Michael Salna, Serge Kobsa, Scott Deroo, Jacob Kriegel, David Blitzer, Nicholas J Shea, Alex D'Angelo, Tasnim Raza, Paul Kurlansky, Koji Takeda, Hiroo Takayama, Vinayak Bapat, Yoshifumi Naka, Craig R Smith, Emile Bacha, and Michael Argenziano.
    • Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York. Electronic address: ig2006@cumc.columbia.edu.
    • Ann. Thorac. Surg. 2020 Oct 1; 110 (4): 1108-1118.

    BackgroundThe onset of the coronavirus disease 2019 (COVID-19) pandemic has forced our cardiac surgery program and hospital to enact drastic measures that has forced us to change how we care for cardiac surgery patients, assist with COVID-19 care, and enable support for the hospital in terms of physical resources, providers, and resident training.MethodsIn this review, we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic, including the use of telemedicine, how a severe reduction in operative volume affected our program, the process of redeployment of staff, repurposing of residents into specific task teams, the creation of operation room intensive care units, and the challenges that we faced in this process.ResultsWe offer a revised set of definitions of surgical priority during this pandemic and how this was applied to our system, followed by specific considerations in coronary/valve, aortic, heart failure and transplant surgery. Finally, we outline a path forward for cardiac surgery for the near future.ConclusionsWe recognize that individual programs around the world will eventually face COVID-19 with varying levels of infection burden and different resources, and we hope this document can assist programs to plan for the future.Copyright © 2020 Jointly between The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, and the European Association for Cardio-Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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