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Cardiothoracic surgery during COVID-19: Our experience with different strategies


1 Department of CTVS, Chief Cardiac Surgeon, Hero DMC Heart Institute, Ludhiana, Punjab, India
2 Department of Cardiac Anaesthesia and Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, India
3 Department of Microbiology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
4 Department of Cardiology, Hero DMC Heart Institute, Ludhiana, Punjab, India
5 Department of CTVS, Hero DMC Heart Institute, Ludhiana, Punjab, India
6 Dayanand Medical College & Hospital, Ludhiana, Punjab, India

Correspondence Address:
Bishav Mohan
Department of Cardiology, Hero DMC Heart Institute, Unit Dayanand Medical College and Hospital, Hero DMC Heart Institute, Tagore Nagar, Civil Lines, Ludhiana, Punjab - 141 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_166_20

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Year : 2020  |  Volume : 23  |  Issue : 4  |  Page : 485-492

 

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Background: An acute respiratory disease (COVID-19), caused by a novel coronavirus (SARS-CoV-2,), has been declared a pandemic by WHO. A surgery on COVID-19 patients not only involves a risk of spread of the disease but also there is a serious concern for the patient's surgical outcomes and resources requirement. Aim: The retrospective study is aimed to provide a protocol for pre-operative testing of SARS CoV-2 using RT-PCR in the patient undergoing cardio-thoracic surgeries. Material and Methods: To analyze the impact of pre-operative testing of SARS- CoV-2 using RT-PCR in the patient undergoing elective cardio-thoracic surgeries. The patient who underwent surgical interventions during the COVID-19 lockdown period was divided into two phases. Phase I (without COVID-19 RT-PCR testing) and Phase II (with pre-operative COVID-19 RT-PCR testing). The retrospective comparison between the two study groups was done using Student t-test, Mann–Whitney U, and Chi square (χ2) test depending upon the clinical variable to be analyzed. Results: During the early phase (phase I), 26 patients underwent cardio-thoracic surgery without COVID-19 RT-PCR test. Whereas, during phase II, all patients were tested for COVID-19 using RT-PCR, preoperatively and a total of 64 surgeries were performed during this phase. One patient planned for CABG was positive on RT-PCR for COVID-19 and was sent to the quarantine ward. The difference in the pre-operative hospital stay between two groups was found to be statistically significant and a significant decrease in the number of PPE kits used, during the phase I. Conclusion: All asymptomatic patients should be tested for COVID-19 using RT-PCR prior to cardio-thoracic surgeries not only to contain the disease but to avoid potential implications of COVID-19 on the perioperative course, without added financial implications.






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1 Department of CTVS, Chief Cardiac Surgeon, Hero DMC Heart Institute, Ludhiana, Punjab, India
2 Department of Cardiac Anaesthesia and Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, India
3 Department of Microbiology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
4 Department of Cardiology, Hero DMC Heart Institute, Ludhiana, Punjab, India
5 Department of CTVS, Hero DMC Heart Institute, Ludhiana, Punjab, India
6 Dayanand Medical College & Hospital, Ludhiana, Punjab, India

Correspondence Address:
Bishav Mohan
Department of Cardiology, Hero DMC Heart Institute, Unit Dayanand Medical College and Hospital, Hero DMC Heart Institute, Tagore Nagar, Civil Lines, Ludhiana, Punjab - 141 001
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_166_20

Rights and Permissions

Background: An acute respiratory disease (COVID-19), caused by a novel coronavirus (SARS-CoV-2,), has been declared a pandemic by WHO. A surgery on COVID-19 patients not only involves a risk of spread of the disease but also there is a serious concern for the patient's surgical outcomes and resources requirement. Aim: The retrospective study is aimed to provide a protocol for pre-operative testing of SARS CoV-2 using RT-PCR in the patient undergoing cardio-thoracic surgeries. Material and Methods: To analyze the impact of pre-operative testing of SARS- CoV-2 using RT-PCR in the patient undergoing elective cardio-thoracic surgeries. The patient who underwent surgical interventions during the COVID-19 lockdown period was divided into two phases. Phase I (without COVID-19 RT-PCR testing) and Phase II (with pre-operative COVID-19 RT-PCR testing). The retrospective comparison between the two study groups was done using Student t-test, Mann–Whitney U, and Chi square (χ2) test depending upon the clinical variable to be analyzed. Results: During the early phase (phase I), 26 patients underwent cardio-thoracic surgery without COVID-19 RT-PCR test. Whereas, during phase II, all patients were tested for COVID-19 using RT-PCR, preoperatively and a total of 64 surgeries were performed during this phase. One patient planned for CABG was positive on RT-PCR for COVID-19 and was sent to the quarantine ward. The difference in the pre-operative hospital stay between two groups was found to be statistically significant and a significant decrease in the number of PPE kits used, during the phase I. Conclusion: All asymptomatic patients should be tested for COVID-19 using RT-PCR prior to cardio-thoracic surgeries not only to contain the disease but to avoid potential implications of COVID-19 on the perioperative course, without added financial implications.






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