Journal of cardiac surgery
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Coronavirus disease 2019 (COVID-19) is usually mild, but patients can present with pneumonia, acute respiratory distress syndrome (ARDS), and circulatory shock. Although the symptoms of the disease are predominantly respiratory, the involvement of the cardiovascular system is common. Patients with heart failure (HF) are particularly vulnerable when suffering from COVID-19. ⋯ HF incidence, prevalence, and undertreatment will grow as a result of new COVID-19-related heart disease. ECMO should be reserved for highly selected cases of COVID-19 with a reasonable probability of recovery. Special considerations are needed for patients with advanced HF, including those supported by durable LVADs.
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Lombardy, in the northern Italy, was one of the most affected region in the world by novel coronavirus COVID-19 outbreak. Due to the dramatic amount of confirmed positive cases and deaths, all clinical and surgical hospital departments changed their daily activities to face emergent pandemic situations. In particular, vascular surgery units reorganized their role and priorities for both elective and urgent patients requiring open or endovascular interventions. ⋯ COVID-19 infection seems to be not only a pulmonary but also a vascular (arterial and venous) disease. Further study are necessary to described mid and long-term outcomes in COVID-19 vascular patients population.
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The current coronavirus disease 2019 (COVID-19) pandemic has a huge impact on society and the economy and represents one of the biggest challenges for healthcare systems all over the world. Reports from healthcare institutions in different countries show a variety of crisis exit strategies. ⋯ Measures to prevent a collapse of the healthcare system were effective. Our local ECMO-Program on the ongoing COVID-19 pandemic has proven to be a useful tool to control mortality and organ failure in critically ill patients.
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During the first phase of coronavirus disease-2019 (COVID-19) pandemic in Italy, several strategies have been taken to deal with the pandemic outbreak. ⋯ During this period, 135 patients were referred to San Raffaele Vascular Surgery Department. COVID-19 was diagnosed in 24 patients and, among them, acute limb ischemia was the most common cause of admission. At this time, the COVID-19 trend is in decline in Italy, and the local authorities reorganized the healthcare system to return to normal activities avoiding new escalations of COVID-19 cases. The COVID-19 pandemic will be remembered in Lombardy as a cataclysm. Nevertheless, the HUB/spoke system has proven to be a valid model in the management of ischemic emergencies. Continuous surveillance, cooperation, coordination, and communication to effectively respond to COVID-19 pandemic is crucial because COVID-19 reference centers could face similar issues in the near future.
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To share the results of a web-based expert panel discussion focusing on the management of acute and chronic aortic disease during the coronavirus (COVID-19) pandemic. ⋯ The current COVID-19 pandemic has-besides the stoppage of elective referrals-also led to a decrease of referrals of acute aortic syndromes in many settings. The reluctance of patients seeking medical help seems to be a major driver. The number of patients, who have been postponed due to the provisioning of ICU resources but having experienced aortic rupture in the waiting period, is still low. Further, studies are needed to learn more about the influence that the COVID-19 pandemic has on the treatment of patients with acute and chronic aortic disease.