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Lockdown surgery: the impact of coronavirus disease 2019 measures on cardiac cases

Felix Nägele1, Clemens Engler1,2, Michael Graber1

  • 1Department of Cardiac Surgery, Medical University of Innsbruck, Austria.

Interactive Cardiovascular and Thoracic Surgery
|April 13, 2022
PubMed

Insights

During the COVID-19 pandemic, cardiac surgery waitlists grew. Despite a 29% drop in procedures and sicker patients during lockdown, outcomes remained stable due to careful patient selection.

Area of Science:

  • Cardiology
  • Surgical Outcomes
  • Pandemic Preparedness

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic necessitated rationing of medical resources, leading to extended wait times for surgical procedures.
  • Understanding the impact of public health interventions like lockdowns on surgical care is crucial for future pandemic planning.

Purpose of the Study:

  • To assess the impact of lockdown periods on the volume, characteristics, and outcomes of cardiac surgery.
  • To compare cardiac surgery data during the first COVID-19 lockdown with pre-lockdown periods and previous years.

Main Methods:

  • A single-centre, cross-sectional descriptive observational study was conducted at the Department of Cardiac Surgery, Medical University of Innsbruck.
  • Data from a quality management system were prospectively collected and retrospectively analyzed, comparing lockdown periods with the preceding 3 years.
  • Primary objective: compare weekly open-heart procedures pre-lockdown vs. during lockdown. Secondary objectives: analyze case characteristics and outcomes.

Main Results:

  • A significant 29% reduction in weekly cardiac surgical procedures was observed during the lockdown period.
  • Patient demographics remained unchanged, but the urgency and severity of cases increased.
  • Despite operating on sicker patients, the surgical case-mix (e.g., valve replacements, bypass grafts) and patient outcomes remained stable.

Conclusions:

  • The quality of open-heart procedures was maintained during the COVID-19 lockdown.
  • Rational patient selection was key to preserving surgical quality despite increased patient acuity and symptom severity.
Abstract

Keywords:
COVID-19Cardiac SurgeryLockdownSARS-CoV-2

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