Adult Cardiac Surgery and the COVID-19 Pandemic: Aggressive Infection Mitigation Strategies Are Necessary in the Operating Room and Surgical Recovery

Daniel T Engelman; Sylvain Lother; Isaac George; Duane J Funk; Gorav Ailawadi; Pavan Atluri; Michael C Grant; Jonathan W Haft; Ansar Hassan; Jean-Francois Legare; Glenn J R Whitman; Rakesh C Arora; Society of Thoracic Surgeons COVID-19 Task Force

doi:10.1016/j.athoracsur.2020.04.007

Adult Cardiac Surgery and the COVID-19 Pandemic: Aggressive Infection Mitigation Strategies Are Necessary in the Operating Room and Surgical Recovery

Ann Thorac Surg. 2020 Aug;110(2):707-711. doi: 10.1016/j.athoracsur.2020.04.007. Epub 2020 Apr 27.

Affiliations

¹ Heart and Vascular Program, Baystate Health, and University of Massachusetts Medical School-Baystate, Springfield, Massachusetts. Electronic address: daniel.engelman@baystatehealth.org.
² Sections of Critical Care and Infectious Diseases, Department of Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
³ Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, New York.
⁴ Section of Critical Care, Departments of Anesthesiology and Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
⁵ Department of Surgery, University of Virginia, Charlottesville, Virginia.
⁶ Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
⁷ Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁸ Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
⁹ New Brunswick Heart Centre, Saint John, New Brunswick, Canada.
¹⁰ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
¹¹ Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada.

Abstract

The COVID-19 pandemic necessitates aggressive infection mitigation strategies to reduce the risk to patients and healthcare providers. This document is intended to provide a framework for the adult cardiac surgeon to consider in this rapidly changing environment. Preoperative, intraoperative, and postoperative detailed protective measures are outlined. These are guidance recommendations during a pandemic surge to be used for all patients while local COVID-19 disease burden remains elevated.

MeSH terms

Betacoronavirus
COVID-19
Cardiac Surgical Procedures
Coronavirus Infections / diagnosis
Coronavirus Infections / epidemiology*
Humans
Intraoperative Care
Operating Rooms / organization & administration*
Pandemics
Pneumonia, Viral / diagnosis
Pneumonia, Viral / epidemiology*
Postoperative Care
Practice Guidelines as Topic
Preoperative Care
SARS-CoV-2
Thoracic Surgery / organization & administration*
Triage