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Comparative Study
. 2021 Sep 14;21(1):434.
doi: 10.1186/s12872-021-02253-6.

The impact of COVID-19 pandemic on aortic valve surgical service: a single centre experience

Dimitrios Vlastos  1 , Ishaansinh Chauhan  2 , Kwabena Mensah  2 , Maria Cannoletta  2 , Athanasios Asonitis  2 , Ahmed Elfadil  2 , Mario Petrou  2 , Anthony De Souza  2 , Cesare Quarto  2 , Sunil K Bhudia  2 , Ulrich Rosendahl  2 , John Pepper  2 , George Asimakopoulos  2
Affiliations
Comparative Study

The impact of COVID-19 pandemic on aortic valve surgical service: a single centre experience

Dimitrios Vlastos et al. BMC Cardiovasc Disord. .

Abstract

Background: The coronavirus-disease 2019 (COVID-19) pandemic imposed an unprecedented burden on the provision of cardiac surgical services. The reallocation of workforce and resources necessitated the postponement of elective operations in this cohort of high-risk patients. We investigated the impact of this outbreak on the aortic valve surgery activity at a single two-site centre in the United Kingdom.

Methods: Data were extracted from the local surgical database, including the demographics, clinical characteristics, and outcomes of patients operated on from March 2020 to May 2020 with only one of the two sites resuming operative activity and compared with the respective 2019 period. A similar comparison was conducted with the period between June 2020 and August 2020, when operative activity was restored at both institutional sites. The experience of centres world-wide was invoked to assess the efficiency of our services.

Results: There was an initial 38.2% reduction in the total number of operations with a 70% reduction in elective cases, compared with a 159% increase in urgent and emergency operations. The attendant surgical risk was significantly higher [median Euroscore II was 2.7 [1.9-5.2] in 2020 versus 2.1 [0.9-3.7] in 2019 (p = 0.005)] but neither 30-day survival nor freedom from major post-operative complications (re-sternotomy for bleeding/tamponade, transient ischemic attack/stroke, renal replacement therapy) was compromised (p > 0.05 for all comparisons). Recommencement of activity at both institutional sites conferred a surgical volume within 17% of the pre-COVID-19 era.

Conclusions: Our institution managed to offer a considerable volume of aortic valve surgical activity over the first COVID-19 outbreak to a cohort of higher-risk patients, without compromising post-operative outcomes. A backlog of elective cases is expected to develop, the accommodation of which after surgical activity normalisation will be crucial to monitor.

Keywords: Adult cardiac surgery; Aortic valve surgery; COVID-19; Pandemic; Service evaluation.

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Conflict of interest statement

We declare no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig. 1
Fig. 1
Surgical aortic valve procedures according to time period
See this image and copyright information in PMC

References

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