Our Summary

This research paper reviews how heart surgery was affected globally during the initial outbreak of COVID-19. The researchers looked at different guidelines and ways cardiac surgery departments were reorganized during the pandemic. They also looked at how heart surgery was handled in Italy, the first western country significantly affected by the virus. In Italy, two methods were used: one involved creating specific centers (‘Hubs’) to perform urgent heart surgeries and others (‘Spokes’) turned into COVID treatment centers. The other method was to gradually reduce the number of surgeries.

The paper also discusses different strategies for deciding which surgeries should go ahead: one approach was flexible and based on the number of COVID-19 patients in the hospital at any given time, while the other was fixed and based solely on the seriousness of the heart condition. The need for protective gear for healthcare workers was also highlighted. The paper concludes by stating that during the pandemic, heart surgeries, like most medical procedures, had to be cut back, with priority given to emergency and non-postponable cases. This was due to the massive demand for healthcare resources to treat COVID-19 patients, which put a significant strain on healthcare systems.

FAQs

  1. How were cardiac surgery departments reorganized during the initial outbreak of COVID-19?
  2. What methods were used in Italy to manage heart surgeries during the pandemic?
  3. How was it decided which heart surgeries would go ahead during the pandemic?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cardiac surgery is to follow pre-operative instructions closely, including any dietary restrictions, medication guidelines, and lifestyle changes. It is important to be as healthy as possible before surgery to improve outcomes and reduce complications. Additionally, patients should communicate openly with their healthcare team about any concerns or questions they may have before undergoing cardiac surgery.

Suitable For

Patients who are typically recommended for cardiac surgery include those with severe coronary artery disease, valvular heart disease, congenital heart defects, and heart failure. These patients may have symptoms such as chest pain, shortness of breath, fatigue, or palpitations. They may also have imaging tests that show significant blockages in the arteries or abnormalities in the heart valves.

In addition, patients who have not responded well to medical treatments or other interventions may be recommended for surgery. This could include patients who continue to have symptoms despite medications, lifestyle changes, or minimally invasive procedures.

Ultimately, the decision to recommend cardiac surgery is made on a case-by-case basis by a multidisciplinary team of healthcare providers, including cardiologists, cardiac surgeons, and other specialists. The goal is to provide the best possible outcome for the patient while minimizing risks and ensuring a successful recovery.

Timeline

Before cardiac surgery:

  • Patient undergoes various diagnostic tests such as echocardiogram, stress test, and coronary angiography to determine the need for surgery.
  • Patient meets with the cardiac surgeon to discuss the procedure, risks, and benefits.
  • Patient may need to make lifestyle changes such as quitting smoking or losing weight to optimize the outcome of surgery.
  • Patient may need to undergo preoperative evaluations and consultations with other medical specialists such as anesthesiologists and cardiologists.

After cardiac surgery:

  • Patient is transferred to the intensive care unit (ICU) immediately after surgery for close monitoring.
  • Patient may need to stay in the hospital for several days to recover and receive postoperative care.
  • Patient undergoes rehabilitation and physical therapy to regain strength and function.
  • Patient is closely monitored for any complications or signs of infection post-surgery.
  • Patient continues to have follow-up appointments with their cardiac surgeon and other medical professionals to monitor their recovery and overall heart health.

What to Ask Your Doctor

  1. What specific precautions are being taken to ensure my safety during and after the surgery, especially in light of the ongoing COVID-19 pandemic?
  2. How will my recovery process be affected by the current healthcare situation, such as potential delays in follow-up appointments or rehabilitation services?
  3. Are there any alternative treatment options or less invasive procedures that could be considered in my case to minimize the risk of exposure to the virus?
  4. What is the hospital’s protocol for managing COVID-19 cases and how will this impact my post-operative care?
  5. How will my surgery be prioritized in the current healthcare environment, and what factors will be considered in determining the urgency of my procedure?
  6. Will there be any changes to the standard post-operative care plan, such as restrictions on visitors or limitations on rehabilitation services?
  7. How will the availability of necessary medical supplies, such as ventilators or personal protective equipment, impact the scheduling and success of my surgery?
  8. Can you provide information on the hospital’s infection control measures and protocols to prevent the spread of COVID-19 during my hospital stay?
  9. How will the current situation affect the availability of specialized healthcare providers, such as anesthesiologists or intensive care unit staff, for my surgery and recovery?
  10. What are the potential risks and benefits of proceeding with cardiac surgery during the pandemic, and how will these be weighed in making a decision about my treatment plan?

Reference

Authors: Bonalumi G, Giambuzzi I, Buratto B, Barili F, Garatti A, Pilozzi Casado A, Di Mauro M, Parolari A; COVID-SICCH Task Force of the Italian Society for Cardiac Surgery. Journal: J Cardiovasc Med (Hagerstown). 2022 Feb 1;23(2):75-83. doi: 10.2459/JCM.0000000000001223. PMID: 34958311