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).