Adult cardiac surgery in Trinidad and Tobago during the COVID-19 pandemic: Lessons from a developing country.

Autor: Ramsingh RAE; Division of Cardiac Surgery, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago.; Department of Cardiology, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago., Duval JL; Medical School, King's College London School of Medicine, London, UK., Rahaman NC; Division of Cardiac Surgery, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago., Rampersad RD; Department of Cardiology, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago., Angelini GD; Department of Cardiac Surgery, Bristol Heart Institute, University of Bristol, Bristol, UK., Teodori G; Division of Cardiac Surgery, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago.
Jazyk: angličtina
Zdroj: Journal of cardiac surgery [J Card Surg] 2020 Dec; Vol. 35 (12), pp. 3387-3390. Date of Electronic Publication: 2020 Aug 26.
DOI: 10.1111/jocs.14975
Abstrakt: 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.
(© 2020 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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