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The Rapid Transformation of Cardiac Surgery Practice in the Coronavirus Disease 2019 (COVID-19) Pandemic: Insights and Clinical Strategies From a Center at the Epicenter.
George, Isaac; Salna, Michael; Kobsa, Serge; Deroo, Scott; Kriegel, Jacob; Blitzer, David; Shea, Nicholas J; D'Angelo, Alex; Raza, Tasnim; Kurlansky, Paul; Takeda, Koji; Takayama, Hiroo; Bapat, Vinayak; Naka, Yoshifumi; Smith, Craig R; Bacha, Emile; Argenziano, Michael.
  • George I; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York. Electronic address: ig2006@cumc.columbia.edu.
  • Salna M; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Kobsa S; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Deroo S; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Kriegel J; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Blitzer D; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Shea NJ; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • D'Angelo A; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Raza T; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Kurlansky P; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Takeda K; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Takayama H; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Bapat V; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Naka Y; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Smith CR; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Bacha E; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
  • Argenziano M; Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
Ann Thorac Surg ; 110(4): 1108-1118, 2020 10.
Article in English | MEDLINE | ID: covidwho-612195
ABSTRACT

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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Cardiovascular Diseases / Telemedicine / Coronavirus Infections / Pandemics / Betacoronavirus / Cardiac Surgical Procedures / Intensive Care Units Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Ann Thorac Surg Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Cardiovascular Diseases / Telemedicine / Coronavirus Infections / Pandemics / Betacoronavirus / Cardiac Surgical Procedures / Intensive Care Units Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Ann Thorac Surg Year: 2020 Document Type: Article