Management of Cardiac Surgery in a Pandemic Region Hospital: Precautions, Results and Experiences During COVID-19.

Abstract

Objective: The aim of the present study was to share the experiences gained from emergency and semiemergency cases of open heart surgery performed during the COVID-19 outbreak in Necmettin Erbakan University Meram Medical Faculty Hospital, which was defined as a pandemic hospital by Turkish Ministry of Health and provided third degree health services.

Materials and methods: A total of 54 patients were retrospectively analyzed between 23 March and 22 May 2020, who were diagnosed to have aortic dissection, coronary artery disease, and heart valve diseases.

Results: Thirty-two CABG, 12 valve surgery, 6 aortic surgery, 4 CABG + valve surgeries were performed. During the postoperative follow-up of 11 patients, who were suspicious of COVID-19, 8 of them displayed respiratory problems and partial oxygen depletion and required continuous positive airway pressure. The hospitalization duration of COVID-19-suspicious patients were approximately 5 days longer than that of normal patients. In one of the patient, who was treated positive for COVID-19, acute coronary syndrome developed and CABG was performed following the treatment.

Conclusion: During the pandemic period, acute cardiac diseases needing urgent surgery could be misdiagnosed because of similar symptoms with COVID-19 and the health care practitioners concentrated with the COVID-19 primarily. On the other hand, pandemic fear could cause delayed admission to the hospital and increased postoperative mortality and morbidity. When a COVID-19-positive or -suspicious patient undergo open-heart surgery, problems resulting from both COVID-19 infection and cardiopulmonary bypass-associated systemic effects could arise. The combination of these two cases could worsen the complications.