The rapid transformation of cardiac surgery practice in the coronavirus disease 2019 (COVID-19) pandemic: Insights and clinical strategies from a center at the epicenter.
Academic Medical Centers
/ organization & administration
Adult
Betacoronavirus
/ isolation & purification
COVID-19
Cardiac Surgical Procedures
/ trends
Cardiovascular Diseases
/ diagnosis
Coronavirus Infections
/ complications
Female
Health Care Rationing
/ methods
Health Services Accessibility
/ organization & administration
Humans
Infection Control
/ methods
Intensive Care Units
/ organization & administration
Male
Middle Aged
New York City
/ epidemiology
Operating Rooms
/ organization & administration
Pandemics
Patient Care Team
/ organization & administration
Perioperative Care
/ methods
Personnel Staffing and Scheduling
/ organization & administration
Pneumonia, Viral
/ complications
SARS-CoV-2
Telemedicine
/ methods
COVID-19
New York
cardiac surgery
pandemic
reorganization
Journal
The Journal of thoracic and cardiovascular surgery
ISSN: 1097-685X
Titre abrégé: J Thorac Cardiovasc Surg
Pays: United States
ID NLM: 0376343
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
14
04
2020
revised:
14
04
2020
accepted:
18
04
2020
pubmed:
7
7
2020
medline:
6
10
2020
entrez:
7
7
2020
Statut:
ppublish
Résumé
The onset of the coronavirus disease 2019 (COVID-19) pandemic has forced our cardiac surgery program and hospital to enact drastic measures that has forced us to change how we care for cardiac surgery patients, assist with COVID-19 care, and enable support for the hospital in terms of physical resources, providers, and resident training. In this review, we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic, including the use of telemedicine, how a severe reduction in operative volume affected our program, the process of redeployment of staff, repurposing of residents into specific task teams, the creation of operation room intensive care units, and the challenges that we faced in this process. We offer a revised set of definitions of surgical priority during this pandemic and how this was applied to our system, followed by specific considerations in coronary/valve, aortic, heart failure and transplant surgery. Finally, we outline a path forward for cardiac surgery for the near future. We recognize that individual programs around the world will eventually face COVID-19 with varying levels of infection burden and different resources, and we hope this document can assist programs to plan for the future.
Sections du résumé
BACKGROUND
The onset of the coronavirus disease 2019 (COVID-19) pandemic has forced our cardiac surgery program and hospital to enact drastic measures that has forced us to change how we care for cardiac surgery patients, assist with COVID-19 care, and enable support for the hospital in terms of physical resources, providers, and resident training.
METHODS
In this review, we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic, including the use of telemedicine, how a severe reduction in operative volume affected our program, the process of redeployment of staff, repurposing of residents into specific task teams, the creation of operation room intensive care units, and the challenges that we faced in this process.
RESULTS
We offer a revised set of definitions of surgical priority during this pandemic and how this was applied to our system, followed by specific considerations in coronary/valve, aortic, heart failure and transplant surgery. Finally, we outline a path forward for cardiac surgery for the near future.
CONCLUSIONS
We recognize that individual programs around the world will eventually face COVID-19 with varying levels of infection burden and different resources, and we hope this document can assist programs to plan for the future.
Identifiants
pubmed: 32624303
pii: S0022-5223(20)31012-6
doi: 10.1016/j.jtcvs.2020.04.060
pmc: PMC7331531
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
937-947.e2Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 Jointly between The American Association for Thoracic Surgery, The Society of Thoracic Surgeons, and the European Association for Cardio-Thoracic Surgery. Published by Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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