Cardiac Surgery During the Coronavirus Disease 2019 Pandemic: Perioperative Considerations and Triage Recommendations

Authors

Vivek Patel
Ernesto Jimenez
Lorraine Cornwell
Trung Tran
David Paniagua
Ali E Denktas
Andrew Chou
Samuel J Hankins
Biykem Bozkurt
Todd K Rosengart
Hani Jneid

Publication Date

7-7-2020

Journal

Journal of the American Heart Association

DOI

10.1161/JAHA.120.017042

PMID

32418460

PMCID

PMC7670528

PubMedCentral® Posted Date

6-18-2020

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Betacoronavirus, COVID-19, Cardiac Surgical Procedures, Comorbidity, Coronavirus Infections, Disease Transmission, Infectious, Heart Diseases, Humans, Pandemics, Perioperative Period, Personal Protective Equipment, Pneumonia, Viral, Practice Guidelines as Topic, SARS-CoV-2, Triage

Abstract

The coronavirus disease 2019 pandemic, caused by severe acute respiratory syndrome coronavirus-2, represents the third human affliction attributed to the highly pathogenic coronavirus in the current century. Because of its highly contagious nature and unprecedented global spread, its aggressive clinical presentation, and the lack of effective treatment, severe acute respiratory syndrome coronavirus-2 infection is causing the loss of thousands of lives and imparting unparalleled strain on healthcare systems around the world. In the current report, we discuss perioperative considerations for patients undergoing cardiac surgery and provide clinicians with recommendations to effectively triage and plan these procedures during the coronavirus disease 2019 outbreak. This will help reduce the risk of exposure to patients and healthcare workers and allocate resources appropriately to those in greatest need. We include an algorithm for preoperative testing for coronavirus disease 2019, personal protective equipment recommendations, and a classification system to categorize and prioritize common cardiac surgery procedures.