Francesco Onorati1, Patrick Myers2, Pietro Bajona3, Andrea Perrotti4, Carlos A Mestres5, Eduard Quintana6. 1. Division of Cardiac Surgery, University Hospital of Verona, Verona, Italy - francesco.onorati@univr.it. 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.
Abstract
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.
BACKGROUND: The aim of this study was to investigate the impact of COVID-19infection 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-19infected 7.4% of staff surgeons, 8.3% of residents and 9.5% of anesthetists. Cardiac surgery caseload declined in 93.4% centers. COVID-19infection 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-19infection 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-19infection among medical personnel and patients, helping the rump up of cardiac surgical practice.
Authors: Silvia Mariani; Maria Elena De Piero; Justine M Ravaux; Alexander Saelmans; Michal J Kawczynski; Bas C T van Bussel; Michele Di Mauro; Anne Willers; Justyna Swol; Mariusz Kowalewski; Tong Li; Thijs S R Delnoij; Iwan C C van der Horst; Jos Maessen; Roberto Lorusso Journal: Artif Organs Date: 2022-05-01 Impact factor: 2.663