Related Experiment Video
Updated: Aug 6, 2026
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Mortality After Cardiovascular Surgery and Procedures During the COVID-19 Pandemic in Ontario, Canada: A
Yuchen Dai1,2, Anna Chu1, J Michael Paterson1,3
1ICES, Toronto, Ontario, Canada.
Insights
COVID-19 reduced cardiovascular procedure volumes for coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) but increased transcatheter aortic valve implantation (TAVI). Mortality rose slightly for CABG, isolated valve surgery (iValve), and PCI.
Area of Science:
- Cardiovascular medicine
- Public health
- Health services research
Background:
- The COVID-19 pandemic significantly impacted global healthcare systems, affecting the delivery of cardiovascular care.
- Understanding the pandemic's influence on the volume and outcomes of major cardiac procedures is crucial for healthcare planning.
Purpose of the Study:
- To compare procedure rates and 30-day mortality for key cardiovascular interventions before and during the COVID-19 pandemic.
- To analyze trends in coronary artery bypass grafting (CABG), isolated valve (iValve) surgery, transcatheter aortic valve implantation (TAVI), and percutaneous coronary intervention (PCI).
Main Methods:
- Retrospective cohort study utilizing health administrative data from Ontario, Canada (April 2018–March 2022).
- Comparison of procedure volumes and 30-day all-cause mortality between the pre-COVID (2018-2020) and COVID (2020-2022) periods.
- Multivariable logistic regression analysis was employed to adjust for potential confounders.
Main Results:
- Procedure volumes decreased for CABG (-18.8%), iValve (-19.3%), and PCI (-14.7%) during the pandemic.
- Transcatheter aortic valve implantation (TAVI) rates increased by 21.4% during the COVID period.
- Adjusted 30-day mortality increased significantly for CABG, iValve, and PCI, while remaining stable for TAVI.
Conclusions:
- The COVID-19 pandemic led to reduced volumes of CABG, iValve, and PCI, accompanied by increased 30-day mortality.
- Despite increased mortality rates, the absolute number of excess deaths associated with these procedures remained small.
Background:
COVID-19 disrupted global healthcare delivery, but its impact on cardiovascular procedure volumes and outcomes remains unclear. We compared rates and outcomes of coronary artery bypass grafting (CABG), isolated open valve (iValve) surgery, combined CABG and valve, other cardiac surgeries, transcatheter aortic valve implantation (TAVI), and percutaneous coronary intervention (PCI) before and during the pandemic.
Methods:
This retrospective cohort study used ICES health administrative data to identify all adults (aged ≥ 18 years) with Ontario Health Insurance Plan coverage who underwent cardiac surgery, TAVI, or PCI between April 2018 and March 2022. The primary outcomes-procedure rates and 30-day all-cause mortality-were compared between the pre-COVID period (April 1, 2018-March 31, 2020) and the COVID period (April 1, 2020-March 31, 2022), the latter using multivariable logistic regression. Secondary outcomes included hospital length of stay and 30-day readmission.
Results:
A total of 41,511 cardiac surgeries, 7138 TAVIs, and 86,549 PCIs were analyzed. During the COVID period, procedure rates declined for CABG (-18.8%), iValve (-19.3%), and PCI (-14.7%), whereas TAVI rates increased by 21.4%. Adjusted 30-day mortality increased for CABG (1.92 [95% confidence interval [CI] 1.69-2.15] to 2.25 [95% CI 2.01-2.49] per 100 procedures; P = 0.043), iValve (2.25 [95% CI 1.78-2.71] to 3.29 [95% CI 2.76-3.82]; P = 0.016), and PCI (2.41 [95% CI 2.28-2.54] to 2.74 [95% CI 2.60-2.88]; P < 0.001), but remained stable for TAVI. One excess death during the COVID period occurred per 303 CABGs, 96 iValves, and 303 PCIs.
Conclusions:
Although CABG, iValve, and PCI volumes declined and 30-day mortality increased during the pandemic, the absolute number of additional deaths remained small.
