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1.
Ann Thorac Surg ; 110(4): 1108-1118, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32591132

RESUMEN

BACKGROUND: The onset of the coronavirus disease 2019 (COVID-19) pandemic has forced our cardiac surgery program and hospital to enact drastic measures that has forced us to change how we care for cardiac surgery patients, assist with COVID-19 care, and enable support for the hospital in terms of physical resources, providers, and resident training. METHODS: In this review, we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic, including the use of telemedicine, how a severe reduction in operative volume affected our program, the process of redeployment of staff, repurposing of residents into specific task teams, the creation of operation room intensive care units, and the challenges that we faced in this process. RESULTS: We offer a revised set of definitions of surgical priority during this pandemic and how this was applied to our system, followed by specific considerations in coronary/valve, aortic, heart failure and transplant surgery. Finally, we outline a path forward for cardiac surgery for the near future. CONCLUSIONS: We recognize that individual programs around the world will eventually face COVID-19 with varying levels of infection burden and different resources, and we hope this document can assist programs to plan for the future.


Asunto(s)
Betacoronavirus , Procedimientos Quirúrgicos Cardíacos/métodos , Enfermedades Cardiovasculares/cirugía , Infecciones por Coronavirus/epidemiología , Unidades de Cuidados Intensivos/organización & administración , Pandemias , Neumonía Viral/epidemiología , Telemedicina/métodos , COVID-19 , Enfermedades Cardiovasculares/epidemiología , Comorbilidad , Salud Global , Humanos , SARS-CoV-2
2.
Eur J Cardiothorac Surg ; 58(4): 667-675, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-32573737

RESUMEN

OBJECTIVES: The onset of the coronavirus disease 2019 (COVID-19) pandemic has forced our cardiac surgery programme and hospital to enact drastic measures that has forced us to change how we care for cardiac surgery patients, assist with COVID-19 care and enable support for the hospital in terms of physical resources, providers and resident training. METHODS: In this review, we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic, including the use of telemedicine, how a severe reduction in operative volume affected our programme, the process of redeployment of staff, repurposing of residents into specific task teams, the creation of operation room intensive care units, and the challenges that we faced in this process. RESULTS: We offer a revised set of definitions of surgical priority during this pandemic and how this was applied to our system, followed by specific considerations in coronary/valve, aortic, heart failure and transplant surgery. Finally, we outline a path forward for cardiac surgery for the near future. CONCLUSIONS: We recognize that individual programmes around the world will eventually face COVID-19 with varying levels of infection burden and different resources, and we hope this document can assist programmes to plan for the future.


Asunto(s)
Centros Médicos Académicos/organización & administración , Betacoronavirus , Procedimientos Quirúrgicos Cardíacos , Enfermedades Cardiovasculares/cirugía , Infecciones por Coronavirus , Asignación de Recursos para la Atención de Salud/organización & administración , Pandemias , Neumonía Viral , Telemedicina/tendencias , COVID-19 , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/virología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Unidades de Cuidados Intensivos/organización & administración , Ciudad de Nueva York/epidemiología , Quirófanos/organización & administración , Pandemias/prevención & control , Grupo de Atención al Paciente/organización & administración , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , SARS-CoV-2 , Telemedicina/métodos , Telemedicina/organización & administración
3.
J Thorac Cardiovasc Surg ; 160(4): 937-947.e2, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32624303

RESUMEN

BACKGROUND: The onset of the coronavirus disease 2019 (COVID-19) pandemic has forced our cardiac surgery program and hospital to enact drastic measures that has forced us to change how we care for cardiac surgery patients, assist with COVID-19 care, and enable support for the hospital in terms of physical resources, providers, and resident training. METHODS: In this review, we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic, including the use of telemedicine, how a severe reduction in operative volume affected our program, the process of redeployment of staff, repurposing of residents into specific task teams, the creation of operation room intensive care units, and the challenges that we faced in this process. RESULTS: We offer a revised set of definitions of surgical priority during this pandemic and how this was applied to our system, followed by specific considerations in coronary/valve, aortic, heart failure and transplant surgery. Finally, we outline a path forward for cardiac surgery for the near future. CONCLUSIONS: We recognize that individual programs around the world will eventually face COVID-19 with varying levels of infection burden and different resources, and we hope this document can assist programs to plan for the future.


Asunto(s)
Centros Médicos Académicos/organización & administración , Betacoronavirus , Procedimientos Quirúrgicos Cardíacos , Infecciones por Coronavirus , Asignación de Recursos para la Atención de Salud , Accesibilidad a los Servicios de Salud/organización & administración , Pandemias , Atención Perioperativa/métodos , Neumonía Viral , Adulto , Betacoronavirus/aislamiento & purificación , COVID-19 , Procedimientos Quirúrgicos Cardíacos/tendencias , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/terapia , Enfermedades Cardiovasculares/virología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Femenino , Asignación de Recursos para la Atención de Salud/métodos , Asignación de Recursos para la Atención de Salud/organización & administración , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Unidades de Cuidados Intensivos/organización & administración , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Quirófanos/organización & administración , Grupo de Atención al Paciente/organización & administración , Admisión y Programación de Personal/organización & administración , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/terapia , SARS-CoV-2 , Telemedicina/métodos , Telemedicina/organización & administración
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