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SARS-CoV-2 (COVID-19) PCR cycle threshold: can it help in the timing of urgent cardiac surgery?
Abdulaziz Alkhulaifi1, Shady Mohammed1, Hafeez Lone1
1Department of Cardiothoracic Surgery, Qatar University, 2713 Doha, Qatar.
Insights
Urgent cardiac surgery can be safely performed in patients diagnosed with COVID-19. Careful preparation, considering virus cycle threshold values, and precise timing are key for successful open-heart operations during the pandemic.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Oncology
Background:
- The COVID-19 pandemic significantly reduced urgent cardiac surgeries due to safety concerns.
- Optimal timing for cardiac surgery in COVID-19 patients remains unclear.
Observation:
- Four patients with varying COVID-19 severity underwent urgent cardiac surgery.
- A strategy was developed based on evolving knowledge of SARS-CoV-2 and PCR cycle threshold (CT) values.
Findings:
- All patients received urgent cardiac surgery after thorough evaluation and multidisciplinary team input.
- Guidance was based on virus CT values obtained from reverse transcription polymerase chain reaction (RT-PCR).
Implications:
- COVID-19 patients can safely undergo open-heart surgery with meticulous planning.
- Consideration of RT-PCR CT values is crucial for determining safe surgical timing.
Background:
The COVID-19 pandemic has resulted in a significant reduction in urgent cardiac surgery due to concerns about safety for both patients and care givers. The timing of safe cardiac surgery is yet to be clarified in the setting of COVID-19 diagnosis.
Methods:
Due to the urgency of the cardiac conditions on presentation, we have operated on four patients who exhibited the spectrum of COVID-19 disease from asymptomatic to severe COVID-19 pneumonia. With the evolving knowledge about SARS-CoV-2 and its genetic determinants as well as the cycle threshold levels obtained from real-time reverse transcription polymerase chain reaction, we have attempted to develop a strategy to deal with these patients.
Results:
All four patients underwent urgent cardiac surgery following a thorough evaluation and multidisciplinary team approach with guidance based on the virus cycle threshold values obtained by reverse transcription polymerase chain reaction.
Conclusion:
We have shown that, with thorough preparations, consideration of the significance of the cycle threshold obtained on reverse transcription polymerase chain reaction and meticulous timing, COVID-19 diagnosed patients may undergo open heart surgery safely.
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