Abstract
Background and AimThe 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.MethodsFrom 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.ResultsThe 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.ConclusionThese 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.
Highlights
The coronavirus disease (COVID‐19), since December 2019, has had vast and far reaching effects in over 190 countries around the world.[1]
Since the importation of the first COVID‐19 case in Trinidad and Tobago on 12th March 2020, aggressive policy measures have been enacted in line with the World Health Organization (WHO) strategic objectives.[3]
The literature pertaining to the effects on cardiac surgical services comes exclusively from large countries that have experienced widespread viral spread and subsequent overwhelming of health care systems, critical care facilities
Summary
The coronavirus disease (COVID‐19), since December 2019, has had vast and far reaching effects in over 190 countries around the world.[1]. The greatest impetus for this came with the exponential rise in COVID‐19 cases in March 2020 that prompted closure of national borders, nationwide lockdown, and suspension of all elective surgeries. With this emergent crisis, brought great uncertainty in healthcare; resources including personal protective equipment (PPE), ventilators, and testing became heavily regulated, new healthcare policies were enacted to ensure safety and reduced transmission, the impacts of which were unforeseeable. 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
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