Journal of cardiac surgery
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The coronavirus disease (COVID-19) has affected a large population across the world. Patients with cardiovascular disease have increased morbidity and mortality due to coronavirus disease. The burden over the health care system has to be reduced in this global pandemic to provide optimal care of patients with COVID-19, as well not compromising those who are in need of emergent cardiovascular care. ⋯ After reviewing a few available guidelines regarding cardiovascular surgery in COVID-19, we conclude to perform only those surgeries which cannot be deferred to a certain period of time, to reduce the burden of the health care system of the country, provide optimal care to patients with COVID-19, and to protect health care workers and cardiovascular patients from COVID-19.
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The coronavirus disease (COVID) pandemic and the decision-making process of whether to perform urgent procedures during a surge are issues that will likely not disappear in the near future as reflected by the current rise in COVID cases in the southern and western United States and the resurgent numbers of confirmed cases around that world leading to are leading to new lock-downs. Multi-disciplinary discussions will continue to be important to decide individual risk and benefit profiles for patients with asymptomatic COVID patients moving forward. While imperfect, this most recent study provides more insight to some of the risks that should be weighed in these discussions. Further prospective, longitudinal research and better understanding of the heterogeneity of the COVID positive patient will further enhance understanding the decision-making process in the cardiac surgical patient through these difficult times.
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Covid-19 was declared a pandemic by the World Health Organization (WHO) on 11 March 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 to increased mortality and morbidity. We reviewed our practice during the initial time of the pandemic, with emphasis on safety protocols. ⋯ While guaranteeing a prompt response to emergent, urgent, and high priority cases, novel safety measures in individual protection, patients circuits, and preoperative diagnoses of symptomatic and asymptomatic infection were adopted. The surgical results corroborate that it was safe to undergo cardiothoracic surgery during the initial time of the Covid-19 pandemic. The new policies will be maintained while the virus stays in the community.
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We aimed to examine the literature evidence behind using extracorporeal membrane oxygenation in COVID-19 patients in a systematic review manner. ⋯ Our study highlights the paucity of evidence and the need for further data to consolidate the efficacy of ECMO in improving patient outcomes. Although ECMO has been shown to be beneficial in a selected group of patients, the recuperative effects of ECMO remain inconclusive. We must ensure that risk-benefit analysis for each candidate is conducted thoroughly so that patients that have increased probability of survival can benefit from this scarce resource.