Joint Recommendations From The Latin American Association of Cardiac and Endovascular Surgery (LACES) and The Cardiovascular Anesthesia Committee of The Latin American Confederation of Anesthesia Societies (CLASA) on the Timing for Cardiac Surgery After COVID-19 Infection

ABSTRACT Introduction: Since the coronavirus disease 2019 (COVID-19) pandemic, cardiac surgeries in patients with previous infection by COVID-19 were suspended or postponed, which led to surgeries performed in patients with an advanced stage of their disease and an increase in the waiting list. There is a heterogeneous attitude in Latin America on the optimal timing to cardiac surgery in patients with previous COVID-19 infection due to scarce data on its outcome. Two Latin American associations joined to establish common suggestions on the optimal timing of surgery in patients with previous COVID-19 infection. Methods: Data collection was performed using a pre-established form, which included year of publication, objective, type of study (prospective/retrospective, descriptive/analytical), number of patients, year of study, waiting time between infection and surgery, type of surgery, morbidity, mortality, and conclusions regarding the association between mortality and morbidity. Final recommendations were approved by the board of directors of Latin American Association of Cardiac and Endovascular Surgery (LACES) and Latin American Confederation of Anesthesia Societies (CLASA). Results: Of the initial 1,016 articles, 11 comprised the final selection. Only six of them included patients who underwent cardiac surgery. According to the analyzed literature, optimal timing for cardiac surgery needs to consider the following aspects: deferable surgery, symptomatic COVID-19 infection, completeness of COVID-19 vaccination. Conclusion: These recommendations derive from the analysis of the scarce literature published at present on outcomes after cardiac surgery in patients with previous COVID-19 infection. These are to be taken as a dynamic recommendation in which Latin American reality was taken into consideration.

Joint Recommendations From The Latin American Association of Cardiac and Endovascular Surgery (LACES) and The Cardiovascular Anesthesia Committee of The Latin American Confederation of Anesthesia Societies (CLASA) on the Timing for Cardiac Surgery After COVID-19 Infection.

INTRODUCTION: Since the coronavirus disease 2019 (COVID-19) pandemic, cardiac surgeries in patients with previous infection by COVID-19 were suspended or postponed, which led to surgeries performed in patients with an advanced stage of their disease and an increase in the waiting list. There is a heterogeneous attitude in Latin America on the optimal timing to cardiac surgery in patients with previous COVID-19 infection due to scarce data on its outcome. Two Latin American associations joined to establish common suggestions on the optimal timing of surgery in patients with previous COVID-19 infection. METHODS: Data collection was performed using a pre-established form, which included year of publication, objective, type of study (prospective/retrospective, descriptive/analytical), number of patients, year of study, waiting time between infection and surgery, type of surgery, morbidity, mortality, and conclusions regarding the association between mortality and morbidity. Final recommendations were approved by the board of directors of Latin American Association of Cardiac and Endovascular Surgery (LACES) and Latin American Confederation of Anesthesia Societies (CLASA). RESULTS: Of the initial 1,016 articles, 11 comprised the final selection. Only six of them included patients who underwent cardiac surgery. According to the analyzed literature, optimal timing for cardiac surgery needs to consider the following aspects: deferable surgery, symptomatic COVID-19 infection, completeness of COVID-19 vaccination. CONCLUSION: These recommendations derive from the analysis of the scarce literature published at present on outcomes after cardiac surgery in patients with previous COVID-19 infection. These are to be taken as a dynamic recommendation in which Latin American reality was taken into consideration.

The panorama for children with heart disease in Colombia / El panorama de los niños con enfermedades cardiacas en Colombia

Abstract Notwithstanding the availability of human and technological resources, the care deficit in the diagnosis and treatment of patients with congenital heart diseases in Colombia is estimated at 50%. Barriers to healthcare delivery and access, both at the basic and specialized level, means that patients progress and reach advanced stages of the disease, with a direct impact on morbidity and mortality, and on the cost of care. Problems in early detection and diagnosis, poor access to specialized institutions, administrative constraints to authorize surgeries, diagnostic tests, and medical services, in addition to the lack of government recognition of national referral centers for the specialized management of these patients, compromise both the quality-of-life and the survival of patients. The purpose of this study is to highlight the current situation of patients and outline the diagnostic impact of the tools widely available in our environment for the detection of these pathologies.

Resumen En Colombia se estima un déficit de atención para el diagnóstico y tratamiento de los pacientes con cardiopatías congénitas del 50%, a pesar de contar con el equipo humano y tecnológico. Las barreras en el acceso a los servicios de salud, tanto en el nivel básico como en el especializado, hacen que los pacientes evolucionen hasta estadios avanzados, con impacto directo en la morbimortalidad y costo de atención. Los problemas en la detección y el diagnóstico temprano, la falta de acceso a centros especializados, las fallas administrativas en las autorizaciones quirúrgicas, diagnósticas y médicas, así como la falta de reconocimiento por parte del Estado de centros de referencia nacional para el manejo especializado de dichos pacientes hacen que tanto la calidad de vida como la sobrevida se encuentren comprometidas. El objetivo de este artículo es resaltar la problemática actual de los pacientes y describir el impacto diagnóstico de las herramientas ampliamente disponibles en nuestro medio para la detección de dichas enfermedades.