.: ORİJİNAL ARAŞTIRMA
Adult Cardiovascular Surgery During COVID-19 Pandemic: A Retrospective Single Center Experience
COVID-19 Pandemisi Sırasında Erişkin Kardiyovasküler Cerrahi: Retrospektif Tek Merkezli Deneyim
Turkiye Klinikleri J Cardiovasc Sci. 2022;34(3):87-96
doi: 10.5336/cardiosci.2022-93651
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Coronavirus disease-2019 (COVID-19), caused by a novel coronavirus, has become a worldwide pandemic. In order to control the global spread of this contagious disease, elective surgeries including cardiac and vascular procedures were postponed. In this article we present our experience during the initial phase of the pandemic in view of safety protocols. Material and Methods: The study included all elective, urgent, and emergent procedures that were performed from March 11, 2020 to June 30, 2021 at the department of cardiovascular surgery. Patients' demographics, preoperative COVID-19 (reverse transcription-polymerase chain reaction) test results, surgical procedures, complications and outcomes were prospectively collected. We also developed our own protocol to proceed with our surgical activity without delay. Results: A total of 86 cardiac and vascular procedures were performed during the study period. The median age was 64 years (range 23-79), 59 (69%) were males. There were 42 (48%) elective procedures, and 13 (15%) patients had emergency procedures. 57 (66%) patients underwent coronary artery bypass graft surgery. 10 (12%) patients underwent valvular procedures. Peripheral vascular surgeries were performed in 18 (21%) patients. The median length of stay in the hospital was 9 days (range 1-60). A positive COVID-19 test was identified in 4 patients, two of them were detected in the immediate postoperative period and died. In-hospital mortality was 9%. Conclusion: Cardiovascular procedures could be performed safely with a relatively low risk during the outbreak, particularly for elective patients with proper management and strict infection control and isolation protocols.
Keywords: COVID-19; coronary artery bypass; infection control; pandemics
Objective: Coronavirus disease-2019 (COVID-19), caused by a novel coronavirus, has become a worldwide pandemic. In order to control the global spread of this contagious disease, elective surgeries including cardiac and vascular procedures were postponed. In this article we present our experience during the initial phase of the pandemic in view of safety protocols. Material and Methods: The study included all elective, urgent, and emergent procedures that were performed from March 11, 2020 to June 30, 2021 at the department of cardiovascular surgery. Patients' demographics, preoperative COVID-19 (reverse transcription-polymerase chain reaction) test results, surgical procedures, complications and outcomes were prospectively collected. We also developed our own protocol to proceed with our surgical activity without delay. Results: A total of 86 cardiac and vascular procedures were performed during the study period. The median age was 64 years (range 23-79), 59 (69%) were males. There were 42 (48%) elective procedures, and 13 (15%) patients had emergency procedures. 57 (66%) patients underwent coronary artery bypass graft surgery. 10 (12%) patients underwent valvular procedures. Peripheral vascular surgeries were performed in 18 (21%) patients. The median length of stay in the hospital was 9 days (range 1-60). A positive COVID-19 test was identified in 4 patients, two of them were detected in the immediate postoperative period and died. In-hospital mortality was 9%. Conclusion: Cardiovascular procedures could be performed safely with a relatively low risk during the outbreak, particularly for elective patients with proper management and strict infection control and isolation protocols.
Keywords: COVID-19; coronary artery bypass; infection control; pandemics
ÖZET
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], dünya çapında bir pandemi hâline geldi. Bu bulaşıcı hastalığın küresel yayılımını kontrol altına almak için alınan tedbirlerden biri; kalp ve damar cerrahi prosedürlerini de içeren elektif ameliyatların ertelenmesidir. Bu yazıda pandeminin ilk aşamasındaki deneyimlerimizi kendi kliniğimizin protokolleri ışığında sunuyoruz. Gereç ve Yöntemler: Çalışma, kardiyovasküler cerrahi bölümünde 11 Mart 2020-30 Haziran 2021 tarihleri arasında gerçekleştirilen tüm elektif, acil ve acil işlemleri içermektedir. Hastaların demografik bilgileri, preoperatif COVID-19 (ters transkriptaz-polimeraz zincir reaksiyonu) test sonuçları, cerrahi prosedürler, komplikasyonlar ve sonuçlar prospektif olarak toplandı. Ayrıca cerrahi faaliyetimize gecikmeden devam etmek için kendi protokolümüzü geliştirdik. Bulgular: Çalışma süresi boyunca toplam 86 kardiyak ve vasküler girişim gerçekleştirildi. Medyan yaş 64 yıl (23-79 arası) olup, 59'u (%69) erkekti. Kırk iki (%48) elektif ameliyat, 13 (%15) hastaya acil prosedür uygulandı. Elli yedi (%66) hastaya koroner arter baypas greft ameliyatı yapıldı. On (%12) hastaya kapak ameliyatı uygulandı. On sekiz (%21) hastaya periferik damar cerrahisi uygulandı. Hastanede medyan kalış süresi 9 gündü (1-60 arası). Dört hastada pozitif COVID-19 testi tespit edildi, 2'si ameliyattan hemen sonra tespit edildi ve hayatını kaybetti. Hastane içi mortalite %9 idi. Sonuç: Kardiyovasküler prosedürler, özellikle uygun yönetim ve sıkı enfeksiyon kontrolü ve izolasyon protokolleri ile elektif hastalar da salgın sırasında nispeten düşük bir riskle güvenli bir şekilde gerçekleştirilebilir.
Anahtar Kelimeler: COVID-19; koroner arter baypas; enfeksiyon kontrolü; pandemik
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], dünya çapında bir pandemi hâline geldi. Bu bulaşıcı hastalığın küresel yayılımını kontrol altına almak için alınan tedbirlerden biri; kalp ve damar cerrahi prosedürlerini de içeren elektif ameliyatların ertelenmesidir. Bu yazıda pandeminin ilk aşamasındaki deneyimlerimizi kendi kliniğimizin protokolleri ışığında sunuyoruz. Gereç ve Yöntemler: Çalışma, kardiyovasküler cerrahi bölümünde 11 Mart 2020-30 Haziran 2021 tarihleri arasında gerçekleştirilen tüm elektif, acil ve acil işlemleri içermektedir. Hastaların demografik bilgileri, preoperatif COVID-19 (ters transkriptaz-polimeraz zincir reaksiyonu) test sonuçları, cerrahi prosedürler, komplikasyonlar ve sonuçlar prospektif olarak toplandı. Ayrıca cerrahi faaliyetimize gecikmeden devam etmek için kendi protokolümüzü geliştirdik. Bulgular: Çalışma süresi boyunca toplam 86 kardiyak ve vasküler girişim gerçekleştirildi. Medyan yaş 64 yıl (23-79 arası) olup, 59'u (%69) erkekti. Kırk iki (%48) elektif ameliyat, 13 (%15) hastaya acil prosedür uygulandı. Elli yedi (%66) hastaya koroner arter baypas greft ameliyatı yapıldı. On (%12) hastaya kapak ameliyatı uygulandı. On sekiz (%21) hastaya periferik damar cerrahisi uygulandı. Hastanede medyan kalış süresi 9 gündü (1-60 arası). Dört hastada pozitif COVID-19 testi tespit edildi, 2'si ameliyattan hemen sonra tespit edildi ve hayatını kaybetti. Hastane içi mortalite %9 idi. Sonuç: Kardiyovasküler prosedürler, özellikle uygun yönetim ve sıkı enfeksiyon kontrolü ve izolasyon protokolleri ile elektif hastalar da salgın sırasında nispeten düşük bir riskle güvenli bir şekilde gerçekleştirilebilir.
Anahtar Kelimeler: COVID-19; koroner arter baypas; enfeksiyon kontrolü; pandemik
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