RESULTS
During the study period a total of 375 patients underwent cardiac surgery in our institution.
Ten patients were diagnosed with COVID-19 in the preoperative screening and subsequently underwent surgery: 4 patients by a positive nasopharyngeal swab, 3 by CT changes in the lung parenchyma and 3 by a combination.
Male sex predominated (80%) and mean age was 65.8 (45 – 76) years. Cardiac diagnosis included: acute coronary syndrome (n=5), acute aortic syndrome (n=1), decompensated mitral regurgitation (n=1), symptomatic severe aortic stenosis (n=1), infective endocarditis (n=1) and infected aortic graft (n=1). (Table 1)
All the patients were discussed at MDTs with input from virologist/infection specialist. In all cases it was agreed that the optimal treatment was surgery without possibility for a less invasive approach.
Four patients were discharged home with medical therapy and readmitted for elective surgery. Mean delay to surgery was 67 (50 – 84) days.
Six patients required urgent treatment during the same admission. Mean delay to surgery was 14.7 (4 – 31) days. They were kept in isolation in a specialised cardiac unit and the screening was repeated every 48 hours until negative tests were obtained and/or the infiltrates disappeared on CXR.
None of the patients developed pyrexia while waiting for the operation and only one patient developed dyspnoea, probably due to acute heart failure.
Mean Euroscore was 3.3 (1.09 – 7.93). Surgical procedures were: CABG (n= 4), CABG + mitral replacement (n= 1), mitral repair (n= 1), AVR (n= 2), aortic replacement (n= 2). Mean bypass and cross clamp time was 122.4 (67 – 305) and 82.8 (36 – 158) minutes respectively. All surgeries were conducted with PPE precautions.
None of the patients developed respiratory complications in the postoperative period and were extubated uneventfully in the first two days. Mechanical ventilation times and length of postoperative stay were not prolonged. Postoperative swabs were negative for all patients.
All patients survived to hospital discharge. (Table 2).