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The Journal of Cardiovascular Surgery 2020 December;61(6):763-8

DOI: 10.23736/S0021-9509.20.11556-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Effects of COVID-19 pandemic on cardiac surgery practice in 61 Hospitals worldwide: results of a survey

Francesco ONORATI 1 , Patrick MYERS 2, Pietro BAJONA 3, Andrea PERROTTI 4, Carlos A. MESTRES 5, Eduard QUINTANA 6

1 Division of Cardiac Surgery, University Hospital of Verona, Verona, Italy; 2 CHUV Cardiovascular Surgery Hospital, Lausanne, Switzerland; 3 Allegheny Health Network, Drexel University Hospital, Pittsburgh, PA, USA; 4 Department of Cardio-Thoracic Surgery, Jean Minjoz University Hospital, Besançon, France; 5 Department of Cardiovascular Surgery, University Hospital of Zürich, Zürich, Switzerland; 6 University Hospital of Barcelona, Barcelona, Spain



BACKGROUND: The aim of this study was to investigate the impact of COVID-19 infection on cardiac surgery community and practice.
METHODS: A 43-question survey was sent to cardiac surgery centers worldwide. The survey analyzed the prepandemic organization of the center, the center’s response to Covid-19 in terms of re-organization pathways, surveillance methods, personal-protective equipment (PPE), and allowed surgical practice with results.
RESULTS: Sixty-one out of 64 centers (95.3%) fulfilled the survey. One third of ICUs were transformed into COVID-19 dedicated-ICUs and one-third moved to another location inside the hospital. Negative-pressure rooms were available in 60.6% centers. Informative measures from hospital administration were received after the first COVID-19 admitted case in 36.1% and during the spread of the infection inside the hospital in 19.6%. Inadequate supply of PPE was common, with no COVID-surveillance of the medical personnel in 4.9% of centers. COVID-19 infected 7.4% of staff surgeons, 8.3% of residents and 9.5% of anesthetists. Cardiac surgery caseload declined in 93.4% centers. COVID-19 infection in patients receiving cardiac surgery resulted in 41-50% mortality in 9.5% centers, and 91-100% mortality in 4.7% centers. Successful weaning with survival from veno-venous extra corporeal membrane oxygenation (ECMO) and veno-arterial ECMO was <50% in 79.2% and 80.0% centers respectively. COVID-19 infection in transplanted patients was rare, with a reported mortality of 0.5% and 1% in one center each.
CONCLUSIONS: There is room for improvement in hospital surveillance, informative measures and PPE to the personnel. These measurements will reduce current spread of COVID-19 infection among medical personnel and patients, helping the rump up of cardiac surgical practice.


KEY WORDS: Severe acute respiratory syndrome coronavirus 2; Cardiac surgical procedures; Extracorporeal Membrane Oxygenation; Transplants

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