Adult: Perioperative Management
Cardiac surgery in North America and coronavirus disease 2019 (COVID-19): Regional variability in burden and impact

https://doi.org/10.1016/j.jtcvs.2020.06.077Get rights and content
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Abstract

Objective

The coronavirus disease 2019 (COVID-19) pandemic has resulted in an increase in hospital resource utilization and the need to defer nonurgent cardiac surgery procedures. The present study aims to report the regional variations of North American adult cardiac surgical case volume and case mix through the first wave of the COVID-19 pandemic.

Methods

A survey was sent to recruit participating adult cardiac surgery centers in North America. Data in regard to changes in institutional and regional cardiac surgical case volume and mix were analyzed.

Results

Our study comprises 67 adult cardiac surgery institutions with diverse geographic distribution across North America, representing annualized case volumes of 60,452 in 2019. Nonurgent surgery was stopped during the month of March 2020 in the majority of centers (96%), resulting in a decline to 45% of baseline with significant regional variation. Hospitals with a high burden of hospitalized patients with COVID-19 demonstrated similar trends of decline in total volume as centers in low burden areas. As a proportion of total surgical volume, there was a relative increase of coronary artery bypass grafting surgery (high +7.2% vs low +4.2%, P = .550), extracorporeal membrane oxygenation (high +2.5% vs low 0.4%, P = .328), and heart transplantation (high +2.7% vs low 0.4%, P = .090), and decline in valvular cases (high –7.6% vs low –2.6%, P = .195).

Conclusions

The present study demonstrates the impact of COVID-19 on North American cardiac surgery institutions as well as helps associate region and COVID-19 burden with the impact on cardiac surgery volumes and case mix.

Key Words

coronavirus disease 2019
COVID-19
cardiac surgery
case volume
cardiovascular surgery

Abbreviations and Acronyms

CABG
coronary artery bypass grafting
COVID-19
coronavirus disease 2019
ECMO
extracorporeal membrane oxygenation
STEMI
ST-elevation myocardial infarction

Cited by (0)

Drs Ad and Luc contributed equally to this article.