IACTS guidelines: practice of cardiovascular and thoracic surgery in the COVID-19 era

Area of Science:

• Cardiovascular and Thoracic Surgery
• Infectious Diseases
• Pulmonary Medicine

Background:

• Patients undergoing cardiovascular and thoracic procedures face heightened morbidity and mortality risks.
• Severe acute respiratory syndrome-corona virus 2 (SARS-CoV-2) exacerbates these risks through its proliferative effects on lung vasculature.
• Systemic inflammatory response syndrome and immunosuppression from surgery/ventilation further complicate patient outcomes.

Purpose of the Study:

• To address the critical need for establishing safe practice guidelines in cardiothoracic surgery during the SARS-CoV-2 pandemic.
• To ensure the safety of both patients and healthcare professionals in the context of novel coronavirus infections.
• To provide a framework for managing cardiothoracic surgical patients at increased risk.

Main Methods:

• This article is a review and guideline proposal.
• It synthesizes current understanding of SARS-CoV-2's impact on cardiopulmonary systems.
• It focuses on risk mitigation strategies and best practices.

Main Results:

• Cardiothoracic patients are uniquely vulnerable to SARS-CoV-2 due to intertwined cardiovascular and pulmonary physiology.
• The virus triggers a cascade of negative effects, including systemic inflammation and immunosuppression.
• Existing surgical and ventilation practices may be complicated by the viral infection.

Conclusions:

• Establishing clear, safe guidelines for cardiothoracic surgery is a priority.
• These guidelines are essential for protecting patients and healthcare teams from SARS-CoV-2 related complications.
• Proactive development of such protocols is crucial for maintaining surgical services during the pandemic.