Management of COVID-19 Patient in Cardiac Surgery with Cardiopulmonary Bypass.

Abstract

Introduction; The diagnosis of COVID-19 is quite challenging due to the inconsistent correlation between laboratory findings, radiological imaging, and the clinical picture and contact history of the patient. The patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) face double risk because CBP triggers an intense inflammatory response and the leading cause of mortality in COVID-19 patients is “cytokine storm”. In our institution 15 confirmed cases operated on with open-heart surgery. 9 cases isolated CABG, 4 cases valvular combined with CABG, and 1 valvular disease.
 Materials and method; All patients undergoing elective or urgent cardiac surgery at “Mother Theresa” ’s Hospital from 11 March to 30 November 2020 were included in this study. Patients diagnosed with COVID-19 infection via positive throat swab taken due to clinical suspicion postoperatively were reviewed. Patients characteristics, type of intervention, date of COVID-19 diagnosis.
 Results: 9 patients (72%) normal recovery, no respiratory failure, only 3-5 days of fever (max 39,4). 3 of them a moderate respiratory failure. 3 patients with severe respiratory failure. Only 3 deaths (26,6%).
 Recommendation: It's important to a preoperative screening for COVID-19 patients.
 The outcome of cardiac surgical patients who contracted COVID-19 infection perioperatively is extremely poor. Aggressive respiratory assistance (early intubation), high doses of corticosteroids, and anticoagulation, better results.