The impact of COVID-19 pandemic on aortic valve surgical service: a
single centre experience.
Abstract
Background The coronavirus-disease 2019 (COVID-19) pandemic imposed an
unprecedented burden on the provision of cardiac surgical services. The
reallocation of workforce and resources necessitated the postponement of
elective operations in this cohort of high-risk patients. We
investigated the impact of this outbreak on the aortic valve surgery
activity at a single two-site centre in the United Kingdom. Methods and
Results Data were extracted from the local surgical database, including
the demographics, clinical characteristics, and outcomes of patients
operated on from March 2020 to May 2020 and compared with the respective
2019 period. The experience of centres world-wide was invoked to assess
the efficiency of our services. There was a 38.2% reduction in the
total number of operations with a 70% reduction in elective cases,
compared with a 159% increase in urgent and emergency operations. The
attendant surgical risk was significantly higher [median Euroscore II
was 2.7 [1.9-5.2] in 2020 versus 2.1 [0.9-3.7] in 2019
(p=0.005)] but neither 30-day survival nor freedom from major
post-operative complications (re-sternotomy for bleeding/tamponade,
transient ischemic attack/stroke, renal replacement therapy) was
compromised (p>0.05 for all comparisons). Conclusion RBHT
managed to offer a considerable volume of aortic valve surgical activity
over the first COVID-19 outbreak to a cohort of higher-risk patients,
without compromising post-operative outcomes. A backlog of elective
cases is expected to develop, the accommodation of which after surgical
activity normalisation will be crucial to monitor.