Timing of cardiac surgery in patients suffering with COVID-19 disease

The current coronavirus (SARS-CoV-2) infection is associated with a high incidence of severe acute respiratory illness (COVID-19 disease), often requiring invasive mechanical ventilation. Owing to the rapid spread of the infection, the World Health Organization (WHO) declared a pandemic on 11 March 2020.¹

                        Reports describe a high rate of mortality and morbidity (prolonged mechanical ventilation) in patients who underwent surgical procedures and were diagnosed with COVID-19 during the peri-operative period.^2,3 In our own experience, developing COVID-19 in the immediate cardiac post-operative period carried a mortality rate of up to 44%.⁴

                        It is difficult to predict the appropriate waiting period between diagnosis of SARS-CoV-2 infection in an asymptomatic patient who requires urgent surgical intervention. Depending on the cardiac diagnosis, there might be an option to treat the patients medically, with less invasive procedures (ie percutaneous coronary intervention [PCI], transcatheter aortic valve implantation [TAVI] or endovascular procedures) or to defer surgery until they test negative for the virus. In this study, the authors aim to identify the earliest safe period for surgery, by analysing their experience in patients who underwent cardiac surgery after recovering from SARS-CoV-2 and COVID-19 disease.