1. The rapid transformation of cardiac surgery practice in the coronavirus disease 2019 (COVID-19) pandemic: Insights and clinical strategies from a center at the epicenter.
- Author
-
George I, Salna M, Kobsa S, Deroo S, Kriegel J, Blitzer D, Shea NJ, D'Angelo A, Raza T, Kurlansky P, Takeda K, Takayama H, Bapat V, Naka Y, Smith CR, Bacha E, and Argenziano M
- Subjects
- Adult, COVID-19, Cardiovascular Diseases diagnosis, Cardiovascular Diseases therapy, Cardiovascular Diseases virology, Female, Humans, Infection Control methods, Infection Control organization & administration, Intensive Care Units organization & administration, Male, Middle Aged, New York City epidemiology, Operating Rooms organization & administration, Patient Care Team organization & administration, Personnel Staffing and Scheduling organization & administration, SARS-CoV-2, Telemedicine methods, Telemedicine organization & administration, Academic Medical Centers organization & administration, Betacoronavirus isolation & purification, Cardiac Surgical Procedures trends, Coronavirus Infections complications, Coronavirus Infections diagnosis, Coronavirus Infections epidemiology, Coronavirus Infections therapy, Health Care Rationing methods, Health Care Rationing organization & administration, Health Services Accessibility organization & administration, Pandemics, Perioperative Care methods, Pneumonia, Viral complications, Pneumonia, Viral diagnosis, Pneumonia, Viral epidemiology, Pneumonia, Viral therapy
- Abstract
Background: The onset of the coronavirus disease 2019 (COVID-19) pandemic has forced our cardiac surgery program and hospital to enact drastic measures that has forced us to change how we care for cardiac surgery patients, assist with COVID-19 care, and enable support for the hospital in terms of physical resources, providers, and resident training., Methods: In this review, we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic, including the use of telemedicine, how a severe reduction in operative volume affected our program, the process of redeployment of staff, repurposing of residents into specific task teams, the creation of operation room intensive care units, and the challenges that we faced in this process., Results: We offer a revised set of definitions of surgical priority during this pandemic and how this was applied to our system, followed by specific considerations in coronary/valve, aortic, heart failure and transplant surgery. Finally, we outline a path forward for cardiac surgery for the near future., Conclusions: We recognize that individual programs around the world will eventually face COVID-19 with varying levels of infection burden and different resources, and we hope this document can assist programs to plan for the future., (Copyright © 2020 Jointly between The American Association for Thoracic Surgery, The Society of Thoracic Surgeons, and the European Association for Cardio-Thoracic Surgery. Published by Elsevier Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF