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The impact of COVID-19 pandemic on aortic valve surgical service: a single centre experience

Dimitrios Vlastos1, Ishaansinh Chauhan2, Kwabena Mensah2

  • 1Royal Brompton and Harefield NHS Foundation Trust, London, UK. dimitrisbvr@hotmail.com.

BMC Cardiovascular Disorders
|September 15, 2021
PubMed

Insights

The COVID-19 pandemic reduced elective aortic valve surgeries but maintained patient safety. Urgent operations increased, yet outcomes remained stable, demonstrating resilience in cardiac surgical services.

Area of Science:

  • Cardiovascular Surgery
  • Epidemiology
  • Public Health

Background:

  • The COVID-19 pandemic significantly impacted healthcare systems globally.
  • Cardiac surgical services faced unprecedented challenges due to resource reallocation.
  • Elective surgeries for high-risk patients, including aortic valve procedures, were often postponed.

Purpose of the Study:

  • To investigate the impact of the COVID-19 outbreak on aortic valve surgery activity.
  • To compare surgical activity and patient outcomes during the pandemic with pre-pandemic periods.
  • To assess the efficiency and safety of aortic valve surgery services during the initial COVID-19 wave.

Main Methods:

  • Retrospective analysis of aortic valve surgery data from a UK center.
  • Comparison of surgical activity between March-May 2020 (reduced capacity) and June-August 2020 (restored capacity) with 2019 data.
  • Inclusion of patient demographics, clinical characteristics, and post-operative outcomes.

Main Results:

  • A 38.2% overall reduction in operations, with a 70% decrease in elective cases, contrasted by a 159% rise in urgent/emergency cases.
  • Increased surgical risk observed in 2020 (median Euroscore II 2.7) compared to 2019 (2.1), p=0.005.
  • No significant compromise in 30-day survival or major post-operative complications; activity returned to within 17% of pre-COVID levels when both sites reopened.

Conclusions:

  • The institution successfully maintained a significant volume of aortic valve surgery during the COVID-19 outbreak for higher-risk patients.
  • Post-operative outcomes were not compromised despite the challenging circumstances.
  • Managing the anticipated backlog of elective cases post-pandemic will be critical.
Abstract

Keywords:
Adult cardiac surgeryAortic valve surgeryCOVID-19PandemicService evaluation

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