Cardiac surgery during SARS COV2 pandemic: when less is more.
Background: During this SARS-CoV-2 pandemic, there has been
unprecedented stress on health care systems, resulting in a change to
how services are carried out. The most prominent question for healthcare
professionals specialising in cardiac surgery is, should we operate
during this pandemic, and to what extent ? Methods: As one of the
biggest, specialised cardiac surgery centres in the UK, we researched
the available published evidence surrounding this question, to formulate
an answer. During this process we considered the potential risks of
cardiac surgery during a pandemic on the patients, staff, the healthcare
system, and the community. We also considered the immunological aspect
of cardiac surgery patients and the risk it entails on them. Results We
have discussed the available evidence and consequences of our findings,
and we found Patients are subjected to greater risk of catching Covid-19
whilst being in hospital. Patient’s immunity is disrupted for up to 3
months post CPB, which makes them more vulnerable to catch the Covid-19
infection during admission and after discharge. Plus the burden on the
whole healthcare system, by using the precious resources and occupying
the necessary staff and hospital beds needed during the pandemic surge.
Conclusion: Try and minimise cardiac surgery operations down to
emergencies or unstable patients who have no other options apart from
surgery, particularly during the surge stage of the pandemic. Strictly
following structured pathways and protocols, updating relevant protocols
with emerging new evidence.