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The Journal of Cardiovascular Surgery 2020 Sep 23

DOI: 10.23736/S0021-9509.20.11556-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

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 of Verona Medical School, Verona, Italy; 2 CHUV Cardiovascular Surgery, Lausanne, Switzerland; 3 Allegheny Health Network, Drexel University College of Medicine, Pittsburgh, PA, USA; 4 Department of Cardio-Thoracic Surgery, University Hospital Jean Minjoz, Besançon, France; 5 Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland; 6 Hospital Clínic de Barcelona, University of Barcelona Medical School, Barcelona, Spain


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BACKGROUND: To investigate the impact of COVID-19 infection on cardiac surgery community and practice.
METHODS: A 43-question survey was sent to cardiac surgery Centres worldwide. The survey analysed the pre-pandemic organization of the Centre, the Centre’s response to Covid-19 in terms of re-organization pathways, surveillance methods, personalprotective equipment (PPE), and allowed surgical practice with results.
RESULTS: Sixty-one out of 64 Centres (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% Centres. 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 Centres. COVID-19 infected 7.4% of staff surgeons , 8.3% of residents and 9.5% of anaesthetists. Cardiac surgery caseload declined in 93.4% Centres. COVID-19 infection in patients receiving cardiac surgery resulted in 41-50% mortality in 9.5% Centres, and 91-100% mortality in 4.7% Centres. Successful weaning with survival from V-V ECMO and V-A ECMO was <50% in 79.2% and 80.0% Centres respectively. COVID-19 infection in transplanted patients was rare, with a reported mortality of 0.5% and 1% in one Centre 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: COVID-19; Cardiac surgery; SARS-CoV-2; ECMO; Transplant

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