• Maks Mihalj, Selim Mosbahi, Juerg Schmidli, Paul Philipp Heinisch, David Reineke, Florian Schoenhoff, Alexander Kadner, Joerg C Schefold, Lorenz Räber, Evgenij V Potapov, and Markus M Luedi.
• Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland. Electronic address: maks.mihalj@insel.ch.
• Best Pract Res Clin Anaesthesiol. 2021 Oct 1; 35 (3): 321332321-332.

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has potentiated the need for implementation of strict safety measures in the medical care of surgical patients - and especially in cardiac surgery patients, who are at a higher risk of COVID-19-associated morbidity and mortality. Such measures not only require minimization of patients' exposure to COVID-19 but also careful balancing of the risks of postponing nonemergent surgical procedures and providing appropriate and timely surgical care. We provide an overview of current evidence for preoperative strategies used in cardiac surgery patients, including risk stratification, telemedicine, logistical challenges during inpatient care, appropriate screening capacity, and decision-making on when to safely operate on COVID-19 patients. Further, we focus on perioperative measures such as safe operating room management and address the dilemma over when to perform cardiovascular surgical procedures in patients at risk.Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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