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Adult cardiac surgery in Trinidad and Tobago during the COVID-19 pandemic: Lessons from a developing country

Richard A E Ramsingh1,2, Jean-Luc Duval3, Natasha C Rahaman1

  • 1Division of Cardiac Surgery, Caribbean Heart Care Medcorp, St. Clair Medical Centre, Port of Spain, Trinidad and Tobago.

Journal of Cardiac Surgery
|August 27, 2020
PubMed

Insights

Cardiac surgery units can safely perform urgent procedures during the COVID-19 pandemic. Strict safety measures, including testing and isolation, protected patients and staff, enabling continued essential cardiac surgery care.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Infectious Disease Epidemiology

Background:

  • The COVID-19 pandemic led to widespread cancellations of elective cardiac surgeries globally.
  • This study details the operational experience of a cardiac surgery unit in a developing nation during the COVID-19 crisis.

Purpose of the Study:

  • To describe the implementation and outcomes of urgent and emergency cardiac surgery during the COVID-19 pandemic.
  • To evaluate the effectiveness of stringent safety protocols in a resource-limited setting.

Main Methods:

  • A prospective database review of 58 patients undergoing urgent/emergency cardiac surgery between April and June 2020.
  • Implementation of a parallel healthcare system with a COVID-19 cold site.
  • Pre-operative patient isolation (1-2 weeks) and COVID-19 polymerase chain reaction testing (72 hours prior).
  • Assignment of discrete, isolated staff exclusively for cardiac surgical cases.

Main Results:

  • The study included 58 patients (mean age 59.7 years; 70.7% male), with high rates of hypertension (90%) and diabetes (55.2%).
  • Coronary artery bypass grafting was performed off-pump in most cases (44/47).
  • No healthcare workers contracted COVID-19; all patients were discharged after rehabilitation.

Conclusions:

  • The implemented safety strategies enabled the continuation of urgent and emergency cardiac surgery.
  • These protocols offer a potential model for other countries preparing to resume elective cardiac surgery post-pandemic.
Abstract

Keywords:
COVID-19Trinidad & Tobagoadult cardiac surgerydeveloping country

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