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Adult cardiac surgery in Trinidad and Tobago during the COVID-19 pandemic: Lessons from a developing country.
Ramsingh, Richard A E; Duval, Jean-Luc; Rahaman, Natasha C; Rampersad, Risshi D; Angelini, Gianni D; Teodori, Giovanni.
  • Ramsingh RAE; Division of Cardiac Surgery, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago.
  • Duval JL; Department of Cardiology, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago.
  • Rahaman NC; Medical School, King's College London School of Medicine, London, UK.
  • Rampersad RD; Division of Cardiac Surgery, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago.
  • Angelini GD; Department of Cardiology, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago.
  • Teodori G; Department of Cardiac Surgery, Bristol Heart Institute, University of Bristol, Bristol, UK.
J Card Surg ; 35(12): 3387-3390, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-730733
ABSTRACT
BACKGROUND AND

AIM:

The coronavirus disease 2019 (COVID-19) pandemic has seen the cancellation of elective cardiac surgeries worldwide. Here we report the experience of a cardiac surgery unit in a developing country in response to the COVID-19 crisis.

METHODS:

From 6th April to 12th June 2020, 58 patients underwent urgent or emergency cardiac surgery. Data was reviewed from a prospectively entered unit-maintained cardiac surgery database. To ensure safe delivery of care to patients, a series of strict measures were implemented which included a parallel healthcare system maintaining a COVID-19 cold site, social isolation of patients for one to 2 weeks before surgery, polymerase chain reaction testing for COVID-19, 72 hours before surgery, discrete staff assigned only to cardiac surgical cases socially isolated for 2 weeks as necessary.

RESULTS:

The mean age at surgery was 59.7 ± 11 years and 41 (70.7%) were male. Fifty-two patients were hypertensive (90%), and 32 were diabetic (55.2%). There were three emergency type A aortic dissections. Forty-seven patients underwent coronary artery bypass graft surgery with all but three performed off-pump. Fourteen cases required blood product transfusion. One patient had postoperative pneumonia associated with chronic obstructive pulmonary disease. The median length of stay was 5.7 ± 1.8 days. All patients were discharged home after rehabilitation. There were no cases of COVID-19 infection among healthcare workers during the study period.

CONCLUSION:

These strategies allowed us to maintain a service for urgent and emergency procedures and may prove useful for larger countries when there is decrease in COVID-19 cases and planning for the restart of elective cardiac surgery.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / SARS-CoV-2 / COVID-19 / Heart Diseases / Cardiac Surgical Procedures Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: English Caribbean / Trinidad and Tobago Language: English Journal: J Card Surg Journal subject: Cardiology Year: 2020 Document Type: Article Affiliation country: Jocs.14975

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / SARS-CoV-2 / COVID-19 / Heart Diseases / Cardiac Surgical Procedures Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: English Caribbean / Trinidad and Tobago Language: English Journal: J Card Surg Journal subject: Cardiology Year: 2020 Document Type: Article Affiliation country: Jocs.14975