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2.
Heart Surg Forum ; 24(5): E906-E908, 2021 Oct 21.
Article in English | MEDLINE | ID: covidwho-1502125

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease that threatens global health. During the pandemic period of COVID-19, the task for prevention in the general ward of cardiovascular surgery is fairly arduous. The present study intends to summarize our experience with infection control, including ward setting, admission procedures, personnel management, health education, and so on, to provide references for clinical management.


Subject(s)
COVID-19/prevention & control , Cardiac Surgical Procedures/standards , Cardiovascular Diseases/epidemiology , Guidelines as Topic , Pandemics/prevention & control , Patients' Rooms/standards , Tertiary Care Centers , COVID-19/epidemiology , Cardiovascular Diseases/surgery , China/epidemiology , Comorbidity , Humans , Retrospective Studies , SARS-CoV-2
4.
Can J Cardiol ; 37(10): 1547-1554, 2021 10.
Article in English | MEDLINE | ID: covidwho-1439940

ABSTRACT

BACKGROUND: The novel SARS-CoV-2 (COVID-19) pandemic has dramatically altered the delivery of healthcare services, resulting in significant referral pattern changes, delayed presentations, and procedural delays. Our objective was to determine the effect of the COVID-19 pandemic on all-cause mortality in patients awaiting commonly performed cardiac procedures. METHODS: Clinical and administrative data sets were linked to identify all adults referred for: (1) percutaneous coronary intervention; (2) coronary artery bypass grafting; (3) valve surgery; and (4) transcatheter aortic valve implantation, from January 2014 to September 2020 in Ontario, Canada. Piece-wise regression models were used to determine the effect of the COVID-19 pandemic on referrals and procedural volume. Multivariable Cox proportional hazards models were used to determine the effect of the pandemic on waitlist mortality for the 4 procedures. RESULTS: We included 584,341 patients who were first-time referrals for 1 of the 4 procedures, of whom 37,718 (6.4%) were referred during the pandemic. The pandemic period was associated with a significant decline in the number of referrals and procedures completed compared with the prepandemic period. Referral during the pandemic period was a significant predictor for increased all-cause mortality for the percutaneous coronary intervention (hazard ratio, 1.83; 95% confidence interval, 1.47-2.27) and coronary artery bypass grafting (hazard ratio, 1.96; 95% confidence interval, 1.28-3.01), but not for surgical valve or transcatheter aortic valve implantation referrals. Procedural wait times were shorter during the pandemic period compared with the prepandemic period. CONCLUSIONS: There was a significant decrease in referrals and procedures completed for cardiac procedures during the pandemic period. Referral during the pandemic was associated with increased all-cause mortality while awaiting coronary revascularization.


Subject(s)
COVID-19 , Cardiovascular Diseases , Coronary Artery Bypass/statistics & numerical data , Delayed Diagnosis , Percutaneous Coronary Intervention/statistics & numerical data , Transcatheter Aortic Valve Replacement/statistics & numerical data , Waiting Lists/mortality , COVID-19/epidemiology , COVID-19/prevention & control , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/mortality , Cardiovascular Diseases/psychology , Cardiovascular Diseases/surgery , Delayed Diagnosis/psychology , Delayed Diagnosis/statistics & numerical data , Delivery of Health Care/statistics & numerical data , Female , Humans , Infection Control/methods , Male , Middle Aged , Mortality , Ontario/epidemiology , SARS-CoV-2 , Time-to-Treatment/organization & administration
5.
JAMA Netw Open ; 4(8): e2121867, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1375583

ABSTRACT

Importance: Postoperative atrial fibrillation (POAF) occurring after cardiac surgery is associated with adverse outcomes. Whether POAF persists beyond discharge is not well defined. Objective: To determine whether continuous cardiac rhythm monitoring enhances detection of POAF among cardiac surgical patients during the first 30 days after hospital discharge compared with usual care. Design, Setting, and Participants: This study is an investigator-initiated, open-label, multicenter, randomized clinical trial conducted at 10 Canadian centers. Enrollment spanned from March 2017 to March 2020, with follow-up through September 11, 2020. As a result of the COVID-19 pandemic, enrollment stopped on July 17, 2020, at which point 85% of the proposed sample size was enrolled. Cardiac surgical patients with CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, prior stroke or transient ischemic attack, vascular disease, age 65-74 years, female sex) score greater than or equal to 4 or greater than or equal to 2 with risk factors for POAF, no history of preoperative AF, and POAF lasting less than 24 hours during hospitalization were enrolled. Interventions: The intervention group underwent continuous cardiac rhythm monitoring with wearable, patch-based monitors for 30 days after randomization. Monitoring was not mandated in the usual care group within 30 days after randomization. Main Outcomes and Measures: The primary outcome was cumulative AF and/or atrial flutter lasting 6 minutes or longer detected by continuous cardiac rhythm monitoring or by a 12-lead electrocardiogram within 30 days of randomization. Prespecified secondary outcomes included cumulative AF lasting 6 hours or longer and 24 hours or longer within 30 days of randomization, death, myocardial infarction, ischemic stroke, non-central nervous system thromboembolism, major bleeding, and oral anticoagulation prescription. Results: Of the 336 patients randomized (163 patients in the intervention group and 173 patients in the usual care group; mean [SD] age, 67.4 [8.1] years; 73 women [21.7%]; median [interquartile range] CHA2DS2-VASc score, 4.0 [3.0-4.0] points), 307 (91.4%) completed the trial. In the intent-to-treat analysis, the primary end point occurred in 32 patients (19.6%) in the intervention group vs 3 patients (1.7%) in the usual care group (absolute difference, 17.9%; 95% CI, 11.5%-24.3%; P < .001). AF lasting 6 hours or longer was detected in 14 patients (8.6%) in the intervention group vs 0 patients in the usual care group (absolute difference, 8.6%; 95% CI, 4.3%-12.9%; P < .001). Conclusions and Relevance: In post-cardiac surgical patients at high risk of stroke, no preoperative AF history, and AF lasting less than 24 hours during hospitalization, continuous monitoring revealed a significant increase in the rate of POAF after discharge that would otherwise not be detected by usual care. Studies are needed to examine whether these patients will benefit from oral anticoagulation therapy. Trial Registration: ClinicalTrials.gov Identifier: NCT02793895.


Subject(s)
Atrial Fibrillation/diagnosis , Atrial Flutter/diagnosis , Cardiac Surgical Procedures/adverse effects , Electrocardiography, Ambulatory/methods , Mass Screening/methods , Patient Discharge , Postoperative Complications/diagnosis , Aged , Atrial Fibrillation/etiology , Atrial Flutter/etiology , COVID-19 , Canada , Cardiovascular Diseases/complications , Cardiovascular Diseases/surgery , Electrocardiography , Female , Hemorrhage , Hospitalization , Humans , Intention to Treat Analysis , Ischemic Attack, Transient , Male , Pandemics , Risk Factors , Stroke , Thromboembolism
6.
Ann Thorac Surg ; 112(5): 1707-1715, 2021 11.
Article in English | MEDLINE | ID: covidwho-1347031

ABSTRACT

EXECUTIVE SUMMARY: Cardiothoracic surgical patients are at risk of increased coronavirus disease severity. Several important factors influence the administration of the coronavirus disease vaccine in the perioperative period. This guidance statement outlines current information regarding vaccine types, summarizes recommendations regarding appropriate timing of administration, and provides information regarding side effects in the perioperative period for cardiac and thoracic surgical patients.


Subject(s)
COVID-19 Vaccines/pharmacology , COVID-19/prevention & control , Cardiovascular Diseases/surgery , Perioperative Care/methods , Practice Guidelines as Topic , Thoracic Surgical Procedures , Vaccination/standards , COVID-19/epidemiology , Cardiovascular Diseases/epidemiology , Comorbidity , Humans , Pandemics
7.
Ann Surg ; 273(4): 630-635, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1304013

ABSTRACT

OBJECTIVE: The aim of the COVER Study is to identify global outcomes and decision making for vascular procedures during the pandemic. BACKGROUND DATA: During its initial peak, there were many reports of delays to vital surgery and the release of several guidelines advising later thresholds for vascular surgical intervention for key conditions. METHODS: An international multi-center observational study of outcomes after open and endovascular interventions. RESULTS: In an analysis of 1103 vascular intervention (57 centers in 19 countries), 71.6% were elective or scheduled procedures. Mean age was 67 ±â€Š14 years (75.6% male). Suspected or confirmed COVID-19 infection was documented in 4.0%. Overall, in-hospital mortality was 11.0% [aortic interventions mortality 15.2% (23/151), amputations 12.1% (28/232), carotid interventions 10.7% (11/103), lower limb revascularisations 9.8% (51/521)]. Chronic obstructive pulmonary disease [odds ratio (OR) 2.02, 95% confidence interval (CI) 1.30-3.15] and active lower respiratory tract infection due to any cause (OR 24.94, 95% CI 12.57-241.70) ware associated with mortality, whereas elective or scheduled cases were lower risk (OR 0.4, 95% CI 0.22-0.73 and 0.60, 95% CI 0.45-0.98, respectively. After adjustment, antiplatelet (OR 0.503, 95% CI: 0.273-0.928) and oral anticoagulation (OR 0.411, 95% CI: 0.205-0.824) were linked to reduced risk of in-hospital mortality. CONCLUSIONS: Mortality after vascular interventions during this period was unexpectedly high. Suspected or confirmed COVID-19 cases were uncommon. Therefore an alternative cause, for example, recommendations for delayed surgery, should be considered. The vascular community must anticipate longer term implications for survival.


Subject(s)
COVID-19/complications , Cardiovascular Diseases/surgery , Vascular Surgical Procedures , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , Cardiovascular Diseases/complications , Cardiovascular Diseases/mortality , Clinical Decision-Making/methods , Endovascular Procedures/mortality , Endovascular Procedures/statistics & numerical data , Female , Global Health , Hospital Mortality , Humans , Logistic Models , Male , Middle Aged , Pandemics , Prospective Studies , Treatment Outcome , Vascular Surgical Procedures/mortality , Vascular Surgical Procedures/statistics & numerical data
9.
PLoS One ; 16(3): e0247282, 2021.
Article in English | MEDLINE | ID: covidwho-1127785

ABSTRACT

Intra-operative autologous blood donation is a blood conservation technique with limited evidence. We evaluated the association between intra-operative autologous blood donation and decrease in peri-operative transfusion in cardiovascular surgery based on evidence from a Japanese administrative database. We extracted the data of patients who had undergone cardiovascular surgery from the Diagnosis Procedure Combination database in Japan (2016-2019). Based on the surgery type, we examined the association of intra-operative autologous blood donation with the transfusion rate and amount of blood used in cardiac and aortic surgeries using multilevel propensity score matching. We enrolled 32,433 and 4,267 patients who underwent cardiac and aortic surgeries and received 5.0% and 6.7% intra-operative autologous blood donation with mean volumes of 557.68 mL and 616.96 mL, respectively. The red blood cell transfusion rates of the control and intra-operative autologous blood donation groups were 60.6% and 38.4%, respectively, in the cardiac surgery cohort (p < .001) and 91.4%, and 83.8%, respectively, in the aortic surgery cohort (p = .037). The transfusion amounts for the control and intra-operative autologous blood donation groups were 5.9 and 3.5 units of red blood cells, respectively, for cardiac surgery patients (p < .001) and 11.9 and 7.9 units, respectively, for aortic surgery patients (p < .001). Intra-operative autologous blood donation could reduce the transfusion rate or amount of red blood cells and fresh frozen plasma for patients undergoing index cardiovascular surgery and could be an effective blood transfusion strategy in cardiovascular surgery for Japanese patients.


Subject(s)
Blood Donors/statistics & numerical data , Blood Transfusion, Autologous/statistics & numerical data , Cardiovascular Diseases/surgery , Adult , Aged , Aged, 80 and over , Erythrocyte Transfusion , Female , Humans , Intraoperative Care , Japan , Male , Middle Aged , Multilevel Analysis , Propensity Score , Retrospective Studies , Young Adult
11.
Ann Surg ; 273(4): 630-635, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1054410

ABSTRACT

OBJECTIVE: The aim of the COVER Study is to identify global outcomes and decision making for vascular procedures during the pandemic. BACKGROUND DATA: During its initial peak, there were many reports of delays to vital surgery and the release of several guidelines advising later thresholds for vascular surgical intervention for key conditions. METHODS: An international multi-center observational study of outcomes after open and endovascular interventions. RESULTS: In an analysis of 1103 vascular intervention (57 centers in 19 countries), 71.6% were elective or scheduled procedures. Mean age was 67 ±â€Š14 years (75.6% male). Suspected or confirmed COVID-19 infection was documented in 4.0%. Overall, in-hospital mortality was 11.0% [aortic interventions mortality 15.2% (23/151), amputations 12.1% (28/232), carotid interventions 10.7% (11/103), lower limb revascularisations 9.8% (51/521)]. Chronic obstructive pulmonary disease [odds ratio (OR) 2.02, 95% confidence interval (CI) 1.30-3.15] and active lower respiratory tract infection due to any cause (OR 24.94, 95% CI 12.57-241.70) ware associated with mortality, whereas elective or scheduled cases were lower risk (OR 0.4, 95% CI 0.22-0.73 and 0.60, 95% CI 0.45-0.98, respectively. After adjustment, antiplatelet (OR 0.503, 95% CI: 0.273-0.928) and oral anticoagulation (OR 0.411, 95% CI: 0.205-0.824) were linked to reduced risk of in-hospital mortality. CONCLUSIONS: Mortality after vascular interventions during this period was unexpectedly high. Suspected or confirmed COVID-19 cases were uncommon. Therefore an alternative cause, for example, recommendations for delayed surgery, should be considered. The vascular community must anticipate longer term implications for survival.


Subject(s)
COVID-19/complications , Cardiovascular Diseases/surgery , Vascular Surgical Procedures , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , Cardiovascular Diseases/complications , Cardiovascular Diseases/mortality , Clinical Decision-Making/methods , Endovascular Procedures/mortality , Endovascular Procedures/statistics & numerical data , Female , Global Health , Hospital Mortality , Humans , Logistic Models , Male , Middle Aged , Pandemics , Prospective Studies , Treatment Outcome , Vascular Surgical Procedures/mortality , Vascular Surgical Procedures/statistics & numerical data
12.
Endocr Metab Immune Disord Drug Targets ; 21(11): 1949-1953, 2021.
Article in English | MEDLINE | ID: covidwho-999951

ABSTRACT

COVID-19 (Virus named as severe acute respiratory syndrome coronavirus 2 (SARS-- CoV-2)) is a pandemic disease characterized by respiratory infection caused by a coronavirus. It has spread worldwide after an outbreak began in Wuhan, China, in December 2019. SARS-CoV-2 has infected more than 15 million people globally. The disease severity and mortality increased in patients with heart-related comorbidities. Cardiovascular disease patients are more susceptible and infected with SARS-CoV-2. Early screening and management of these patients prevent or ameliorate adverse outcomes. Several treatments have been used to combat these effects, as previously seen in MERS and SARS. This review will cover the association of cardiovascular diseases with COVID 19. It showed that cardiovascular diseases are common in patients with COVID- 19. Increased attention to highlight the gaps should be paid to the care of this unique group of patients.


Subject(s)
COVID-19/epidemiology , Cardiovascular Diseases/epidemiology , SARS-CoV-2/pathogenicity , COVID-19/therapy , COVID-19/virology , Cardiovascular Diseases/surgery , Cardiovascular Diseases/virology , Comorbidity , Heart Transplantation , Host-Pathogen Interactions , Humans , Prognosis , Risk Assessment , Risk Factors
13.
Catheter Cardiovasc Interv ; 97(5): 927-937, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-985973

ABSTRACT

BACKGROUND: During COVID-19 pandemic in Spain, elective procedures were canceled or postponed, mainly due to health care systems overwhelming. OBJECTIVE: The objective of this study was to evaluate the consequences of interrupting invasive procedures in patients with chronic cardiac diseases due to the COVID-19 outbreak in Spain. METHODS: The study population is comprised of 2,158 patients that were pending on elective cardiac invasive procedures in 37 hospitals in Spain on the 14th of March 2020, when a state of alarm and subsequent lockdown was declared in Spain due to the COVID-19 pandemic. These patients were followed-up until April 31th. RESULTS: Out of the 2,158 patients, 36 (1.7%) died. Mortality was significantly higher in patients pending on structural procedures (4.5% vs. 0.8%, respectively; p < .001), in those >80 year-old (5.1% vs. 0.7%, p < .001), and in presence of diabetes (2.7% vs. 0.9%, p = .001), hypertension (2.0% vs. 0.6%, p = .014), hypercholesterolemia (2.0% vs. 0.9%, p = .026) [Correction added on December 23, 2020, after first online publication: as per Dr. Moreno's request changes in p-values were made after original publication in Abstract.], chronic renal failure (6.0% vs. 1.2%, p < .001), NYHA > II (3.8% vs. 1.2%, p = .001), and CCS > II (4.2% vs. 1.4%, p = .013), whereas was it was significantly lower in smokers (0.5% vs. 1.9%, p = .013). Multivariable analysis identified age > 80, diabetes, renal failure and CCS > II as independent predictors for mortality. CONCLUSION: Mortality at 45 days during COVID-19 outbreak in patients with chronic cardiovascular diseases included in a waiting list due to cancellation of invasive elective procedures was 1.7%. Some clinical characteristics may be of help in patient selection for being promptly treated when similar situations happen in the future.


Subject(s)
COVID-19/epidemiology , Cardiac Surgical Procedures/statistics & numerical data , Cardiovascular Diseases/surgery , Elective Surgical Procedures/statistics & numerical data , Pandemics , SARS-CoV-2 , Waiting Lists , Aged , Aged, 80 and over , Cardiovascular Diseases/epidemiology , Comorbidity , Female , Humans , Male , Spain/epidemiology
14.
J Biomed Inform ; 113: 103657, 2021 01.
Article in English | MEDLINE | ID: covidwho-970257

ABSTRACT

OBJECTIVE: During the COVID-19 pandemic, health systems postponed non-essential medical procedures to accommodate surge of critically-ill patients. The long-term consequences of delaying procedures in response to COVID-19 remains unknown. We developed a high-throughput approach to understand the impact of delaying procedures on patient health outcomes using electronic health record (EHR) data. MATERIALS AND METHODS: We used EHR data from Vanderbilt University Medical Center's (VUMC) Research and Synthetic Derivatives. Elective procedures and non-urgent visits were suspended at VUMC between March 18, 2020 and April 24, 2020. Surgical procedure data from this period were compared to a similar timeframe in 2019. Potential adverse impact of delay in cardiovascular and cancer-related procedures was evaluated using EHR data collected from January 1, 1993 to March 17, 2020. For surgical procedure delay, outcomes included length of hospitalization (days), mortality during hospitalization, and readmission within six months. For screening procedure delay, outcomes included 5-year survival and cancer stage at diagnosis. RESULTS: We identified 416 surgical procedures that were negatively impacted during the COVID-19 pandemic compared to the same timeframe in 2019. Using retrospective data, we found 27 significant associations between procedure delay and adverse patient outcomes. Clinician review indicated that 88.9% of the significant associations were plausible and potentially clinically significant. Analytic pipelines for this study are available online. CONCLUSION: Our approach enables health systems to identify medical procedures affected by the COVID-19 pandemic and evaluate the effect of delay, enabling them to communicate effectively with patients and prioritize rescheduling to minimize adverse patient outcomes.


Subject(s)
COVID-19/epidemiology , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/surgery , Neoplasms/diagnosis , Neoplasms/surgery , Pandemics , Time-to-Treatment , Adult , COVID-19/virology , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/isolation & purification
16.
Arq. bras. cardiol ; 115(1): 111-126, jul. 2020. graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-722291

ABSTRACT

Resumo A pandemia da doença causada pelo novo coronavírus (COVID-19) trouxe grandes desafios para o sistema de saúde devido ao aumento exponencial do número de pacientes acometidos. A racionalização de recursos e a indicação correta e criteriosa de exames de imagem e procedimentos intervencionistas tornaram-se necessárias, priorizando a segurança do paciente, do ambiente e dos profissionais da saúde. Esta revisão visa auxiliar e orientar os profissionais envolvidos na realização desses exames e procedimentos a fazê-los de forma eficaz e segura.


Abstract The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.


Subject(s)
Humans , Pneumonia, Viral/complications , Cardiovascular Surgical Procedures/statistics & numerical data , Cardiovascular Diseases/surgery , Practice Guidelines as Topic , Coronavirus Infections/complications , Betacoronavirus , Pneumonia, Viral/epidemiology , Echocardiography , Cardiovascular Diseases/complications , Cardiovascular Diseases/diagnostic imaging , Coronavirus Infections/epidemiology , Communicable Diseases, Emerging/epidemiology , Pandemics , SARS-CoV-2 , COVID-19
17.
J Card Surg ; 35(10): 2768-2772, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-645571

ABSTRACT

BACKGROUND: 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. METHODS: There is a very limited data published defining which cardiovascular procedures are to be performed or to be deferred in the COVID-19 pandemic. In this article, we have reviewed a few published guidelines regarding cardiovascular surgery in COVID-19 pandemics. CONCLUSION: 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.


Subject(s)
Betacoronavirus , Cardiovascular Diseases/surgery , Cardiovascular Surgical Procedures/standards , Coronavirus Infections/epidemiology , Disease Transmission, Infectious/prevention & control , Elective Surgical Procedures/methods , Pandemics , Pneumonia, Viral/epidemiology , COVID-19 , Cardiovascular Diseases/epidemiology , Comorbidity , Coronavirus Infections/transmission , Humans , Pneumonia, Viral/transmission , SARS-CoV-2
18.
J Invasive Cardiol ; 32(7): E178-E181, 2020 07.
Article in English | MEDLINE | ID: covidwho-626479

ABSTRACT

BACKGROUND: COVID-19 has led to major changes in hospital systems across the world. In an effort to reduce viral transmission, conserve resources, and in accordance with institutional and state mandates, all elective procedures and surgeries were postponed during the initial outbreak. Guidelines for case selection are limited and management for pediatric catheterization laboratories during this crisis is unprecedented. OBJECTIVES: To report the protocols and case selection of a high-volume pediatric cardiac catheterization laboratory in the epicenter of the novel coronavirus (COVID-19) pandemic. METHODS: All pediatric cardiac catheterization procedures from March 16, 2020 through May 10, 2020 were reviewed. Changes to case selection and periprocedural workflow are described. Data were collected on COVID-19 testing status and primary procedure type, and all procedures were classified by urgency. RESULTS: There were 52 catheterizations performed on 50 patients. Endomyocardial biopsies were the most common procedure (n = 27; 52%). Interventional and diagnostic procedures represented 27% (n = 14) and 21% (n = 11) of cases, respectively. Two emergent procedures (3.8%) were performed on patients with positive COVID-19 testing. Most cases were performed on patients with negative COVID-19 testing (n = 33; 94%). CONCLUSIONS: Adjusting to the COVID-19 pandemic in a high-volume pediatric cardiac catheterization laboratory can be safely and effectively managed by prioritizing emergent and urgent cases and modifying workflow operations. The experience of this center may assist other pediatric cardiac catheterization laboratories in adapting to similar practice changes as the pandemic continues to evolve.


Subject(s)
Cardiac Catheterization , Cardiovascular Diseases , Coronavirus Infections , Critical Pathways , Infection Control , Pandemics , Patient Selection , Pneumonia, Viral , Betacoronavirus/isolation & purification , COVID-19 , Cardiac Catheterization/methods , Cardiac Catheterization/statistics & numerical data , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/surgery , Child , Clinical Protocols , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Critical Pathways/organization & administration , Critical Pathways/trends , Female , Humans , Infection Control/methods , Infection Control/organization & administration , Male , New York/epidemiology , Organizational Innovation , Outcome and Process Assessment, Health Care , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , SARS-CoV-2
19.
JACC Cardiovasc Interv ; 13(16): 1949-1950, 2020 08 24.
Article in English | MEDLINE | ID: covidwho-306087

ABSTRACT

The coronavirus disease-19 (COVID-19) period have dictated a different approach to cardiac interventions at our medical institution. We prioritize emergent care geared toward lesser invasive approaches while minimizing hospitalization duration. This reflects upon coronary and structural/valvular cases altogether. Despite potential criticism of this approach, we believe it is the most appropriate therapeutic strategy for this unique period. Further investigation is needed to examine the external validity of our approach in other medical centers worldwide.


Subject(s)
Betacoronavirus , Cardiac Surgical Procedures/standards , Cardiovascular Diseases/surgery , Coronavirus Infections/complications , Disease Management , Guideline Adherence , Pandemics , Pneumonia, Viral/complications , COVID-19 , Cardiovascular Diseases/complications , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , SARS-CoV-2
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