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Adult cardiac surgery during COVID-19 lockdown: Impact on activity and outcomes in a high-volume centre.
Nader, Joseph; Anselmi, Amedeo; Tomasi, Jacques; Martin, Amandine; Aymami, Marie; Rouze, Simon; Corbineau, Hervé; Langanay, Thierry; Flecher, Erwan; Nesseler, Nicolas; Verhoye, Jean-Philippe.
  • Nader J; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
  • Anselmi A; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France. Electronic address: amedeo.anselmi@chu-rennes.fr.
  • Tomasi J; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
  • Martin A; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
  • Aymami M; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
  • Rouze S; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
  • Corbineau H; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
  • Langanay T; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
  • Flecher E; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
  • Nesseler N; Division of cardiac anaesthesia, Rennes university hospital, 35000 Rennes, France.
  • Verhoye JP; Division of thoracic and cardiovascular surgery, Rennes university hospital, 35000 Rennes, France.
Arch Cardiovasc Dis ; 114(5): 364-370, 2021 May.
Article in English | MEDLINE | ID: covidwho-1064692
ABSTRACT

BACKGROUND:

The coronavirus disease 2019 (COVID-19) outbreak had a direct impact on adult cardiac surgery activity, which systematically necessitates a postoperative stay in intensive care.

AIM:

To study the effect of the COVID-19 lockdown on cardiac surgery activity and outcomes, by making a comparison with the corresponding period in 2019.

METHODS:

This prospective observational cohort study compared adult cardiac surgery activity in our high-volume referral university hospital from 9 March to 10 May 2020 versus 9 March to 10 May 2019. Data were collected in our local certified database and a national database sponsored by the French society of thoracic and cardiovascular surgery. The primary study endpoints were operative mortality and postoperative complications.

RESULTS:

With 105 interventions in 2020, our activity dropped by 57% compared with the same period in 2019. Patients were at higher risk, with a significantly higher EuroSCORE II score (3.8±4.5% vs. 2.0±1.8%; P<0.001) and higher rates of active endocarditis (7.6% vs. 2.9%; P=0.047) and recent myocardial infarction (9.5% vs. 0%; P<0.001). The weight and priority of the interventions were significantly different in 2020 (P=0.019 and P<0.001, respectively). The rate of acute aortic syndromes was also significantly higher in 2020 (P<0.001). Operative mortality was higher during the lockdown period (5.7% vs. 1.7%; P=0.038). The postoperative course was more complicated in 2020, with more postoperative bleeding (P=0.003), mechanical circulatory support (P=0.032) and prolonged mechanical ventilation (P=0.005). Only two patients (1.8%) developed a positive status for severe acute respiratory syndrome coronavirus 2 after discharge.

CONCLUSIONS:

Adult cardiac surgery was heavily affected by the COVID-19 lockdown. A further modulation plan is necessary to improve outcomes and reduce postponed operations to decrease operative mortality and morbidity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quarantine / Pandemics / Hospitals, High-Volume / SARS-CoV-2 / COVID-19 / Cardiac Surgical Procedures Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Arch Cardiovasc Dis Journal subject: Vascular Diseases / Cardiology Year: 2021 Document Type: Article Affiliation country: J.acvd.2020.12.003

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quarantine / Pandemics / Hospitals, High-Volume / SARS-CoV-2 / COVID-19 / Cardiac Surgical Procedures Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Arch Cardiovasc Dis Journal subject: Vascular Diseases / Cardiology Year: 2021 Document Type: Article Affiliation country: J.acvd.2020.12.003