Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Apr 29;59(4):901-907.
doi: 10.1093/ejcts/ezaa436.

Cardiac surgery practice during the COVID-19 outbreak: a multicentre national survey

Antonino Salvatore Rubino  1 , Luca Salvatore De Santo  1 , Antonio Pisano  2 , Michele di Mauro  3 , Stefano Benussi  4 , Valentino Borghetti  5 , Alessandro Castiglioni  6 , Luigi Chiariello  7 , Andrea Colli  8 , Antonio De Bellis  9 , Carlo Maria De Filippo  10 , Ruggero De Paulis  11 , Giuseppe Di Benedetto  12 , Marco Di Eusanio  13 , Giuseppe Faggian  14 , Brenno Fiorani  15 , Pasquale Antonio Fratto  16 , Angelo Giuseppe Giuffrida  17 , Mattia Glauber  18 , Gabriele Iannelli  19 , Severino Iesu  20 , Ugolino Livi  21 , Gianluca Martinelli  22 , Massimo Massetti  23 , Pasquale Mastroroberto  24 , Lorenzo Menicanti  25 , Giuseppe Minniti  26 , Fabio Miraldi  27 , Gianfranco Montesi  28 , Francesco Musumeci  29 , Francesco Nicolini  30 , Carlo Pace Napoleone  31 , Paolo Panisi  32 , Aniello Pappalardo  33 , Francesco Patanè  34 , Temistocle Ragni  35 , Mauro Rinaldi  36 , Salvatore Tribastone  37 , Michele Triggiani  38 , Francesco Paolo Tritto  39 , Carlo Zebele  40 , Alessandro Parolari  41 , Gino Gerosa  42 , Marisa De Feo  1 ; Italian Society for Cardiac Surgery Task Force on COVID-19 Pandemic
Collaborators, Affiliations
Multicenter Study

Cardiac surgery practice during the COVID-19 outbreak: a multicentre national survey

Antonino Salvatore Rubino et al. Eur J Cardiothorac Surg. .

Abstract

Objectives: Healthcare systems worldwide have been overburdened by the coronavirus disease 2019 (COVID-19) outbreak. Accordingly, hospitals had to implement strategies to profoundly reshape both non-COVID-19 medical care and surgical activities. Knowledge about the impact of the COVID-19 pandemic on cardiac surgery practice is pivotal. The goal of the present study was to describe the changes in cardiac surgery practices during the health emergency at the national level.

Methods: A 26-question web-enabled survey including all adult cardiac surgery units in Italy was conducted to assess how their clinical practice changed during the national lockdown. Data were compared to data from the corresponding period in 2019.

Results: All but 2 centres (94.9%) adopted specific protocols to screen patients and personnel. A significant reduction in the number of dedicated cardiac intensive care unit beds (-35.4%) and operating rooms (-29.2%), along with healthcare personnel reallocation to COVID departments (nurses -15.4%, anaesthesiologists -7.7%), was noted. Overall adult cardiac surgery volumes were dramatically reduced (1734 procedures vs 3447; P < 0.001), with a significant drop in elective procedures [580 (33.4%) vs 2420 (70.2%)].

Conclusions: This national survey found major changes in cardiac surgery practice as a response to the COVID-19 pandemic. This experience should lead to the development of permanent systems-based plans to face possible future pandemics. These data may effectively help policy decision-making in prioritizing healthcare resource reallocation during the ongoing pandemic and once the healthcare emergency is over.

Keywords: COVID-19 pandemic; Cardiac surgery; Healthcare resources; Prioritization; Waiting list.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Proportion of centres stratified by resource reallocation to treat COVID-19.
None
See this image and copyright information in PMC

References

    1. Rosenbaum L. Facing Covid-19 in Italy—ethics, logistics, and therapeutics on the epidemic's front line. N Engl J Med 2020;382:1873–5. - PubMed
    1. Eurostat. Healthcare Resource Statistics—Beds. https://ec.europa.eu/eurostat/statistics-explained/index.php/Healthcare_... (22 May 2020, date last accessed),
    1. Vergano M, Bertolini G, Giannini A, Gristina GR, Livigni S, Mistraletti G et al. Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: the Italian perspective during the COVID-19 epidemic. Version 2. Crit Care 2020;24:165. - PMC - PubMed
    1. Giordano A, Biondi-Zoccai G, Frati G, Bartorelli AL. Management of structural heart disease and acute coronary syndromes in the COVID-19 pandemic. Curr Atheroscler Rep 2020;22:29. - PMC - PubMed
    1. Pisano A, Landoni G, Zangrillo A. Protecting high-risk cardiac patients during the COVID-19 outbreak. J Cardiothorac Vasc Anesth 2020;34:1698. - PMC - PubMed

Publication types