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Non-Elective Pediatric Cardiac Catheterization During COVID-19 Pandemic: A New York Center Experience
Kristin T Oshiro, Mariel E Turner, Alejandro J Torres
1Division of Pediatric Cardiology, Columbia University Irving Medical Center, 3959 Broadway-2N, New York, NY 10032 USA. omb2104@cumc.columbia.edu.
Insights
Pediatric cardiac catheterization labs can safely manage COVID-19 by prioritizing urgent cases and modifying workflows. This approach ensured continued care during the pandemic while minimizing viral transmission risks.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Infectious Disease Management
Background:
- The COVID-19 pandemic necessitated significant changes in hospital operations, including the postponement of elective procedures.
- Limited guidelines exist for managing pediatric cardiac catheterization laboratories during public health crises.
- Adapting to novel coronavirus (COVID-19) protocols was unprecedented for pediatric cardiac catheterization services.
Purpose of the Study:
- To detail the protocols and case selection strategies implemented in a high-volume pediatric cardiac catheterization laboratory during the COVID-19 pandemic.
- To provide insights into managing cardiac catheterization procedures amidst a global health crisis.
Main Methods:
- Review of all pediatric cardiac catheterization procedures performed between March 16, 2020, and May 10, 2020.
- Analysis of changes in case selection criteria and periprocedural workflows.
- Classification of procedures by urgency and collection of data on COVID-19 testing status.
Main Results:
- A total of 52 procedures were performed on 50 patients.
- Endomyocardial biopsies constituted the majority of procedures (52%).
- Two emergent procedures (3.8%) were performed on COVID-19 positive patients; most procedures (94%) were on COVID-19 negative patients.
Conclusions:
- Pediatric cardiac catheterization laboratories can adapt to the COVID-19 pandemic by prioritizing emergent/urgent cases and modifying workflows.
- This center's experience offers a model for other laboratories facing similar challenges.
- Safe and effective management of pediatric cardiac catheterization is achievable during pandemics.
Background:
COVID-19 has led to major changes in hospital systems across the world. In an effort to reduce viral transmission, conserve resources, and in accordance with institutional and state mandates, all elective procedures and surgeries were postponed during the initial outbreak. Guidelines for case selection are limited and management for pediatric catheterization laboratories during this crisis is unprecedented.
Objectives:
To report the protocols and case selection of a high-volume pediatric cardiac catheterization laboratory in the epicenter of the novel coronavirus (COVID-19) pandemic.
Methods:
All pediatric cardiac catheterization procedures from March 16, 2020 through May 10, 2020 were reviewed. Changes to case selection and periprocedural workflow are described. Data were collected on COVID-19 testing status and primary procedure type, and all procedures were classified by urgency.
Results:
There were 52 catheterizations performed on 50 patients. Endomyocardial biopsies were the most common procedure (n = 27; 52%). Interventional and diagnostic procedures represented 27% (n = 14) and 21% (n = 11) of cases, respectively. Two emergent procedures (3.8%) were performed on patients with positive COVID-19 testing. Most cases were performed on patients with negative COVID-19 testing (n = 33; 94%).
Conclusions:
Adjusting to the COVID-19 pandemic in a high-volume pediatric cardiac catheterization laboratory can be safely and effectively managed by prioritizing emergent and urgent cases and modifying workflow operations. The experience of this center may assist other pediatric cardiac catheterization laboratories in adapting to similar practice changes as the pandemic continues to evolve.
