Abstract
Background: Health care is seriously affected by the corona virus disease 2019 (COVID-19) pandemic with alarming effects upon conduct of cardiac surgery. The initial resource conservation strategy has to modify for handling the surging case load due to deference of routine care in the face of pandemic. Methods: The cardiac surgical practice during the lockdown period (from 25th March till 30TH November 2020) at a tertiary care centre was observed. The cardiac diagnosis of the ones operated, conduct algorithm, and working policy were analyzed. Descriptive statistics was applied to calculate the percentages of different case subsets in both adult and pediatrics groups. Results: Total of 333 emergency cases were operated on during the time frame from 25thMarch 2020 to 30thNovember 2020. Cases were divided into adult and pediatric cases. Total adult cases were 160 (48%) in number. Adult cases were further classified into aortic cases, coronary artery disease, valvular pathologies and miscellaneous ones. Total 11 aortic cases (6.8%), 43 CABG cases (26.8%), 42 valvular cases (26.2%) and 83 miscellaneous cases (51.8%) were operated. In the pediatric population, a total of 173 cases (52%) were operated, with 42 cases (24.2%) being arterial switch operations, one case of ALCAPA repair (0.5%), 25 cases (14.4%) of TAPVC repair and others (60.6%). All cases were preoperatively COVID-19 negative. However postoperatively 10 patients (3%) showed symptoms of COVID-19 and on testing turned out to be COVID-19 positive. 8 patients (80%) were transferred to dedicated COVID-19 facility for management and later 6 (60%) were discharged after successful management. There was no COVID-19-related mortality and none of the health-care workers developed COVID-19 in the entire study period. Conclusion: The initial phase of resource conservation has undermined the routine cardiac surgical practice. The study showed that strict adherence to management algorithm is necessary for persisting smooth continuation of cardiac surgical practice with provision of optimum critical care. The strategic comeback against COVID-19 would urge institutional development of protocols to aid the post-surge period.
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