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关于COVID-19大流行期间主动脉瓣置换术(AVR)操作可能变化的注意事项。

Caution regarding potential changes in AVR practices during the COVID-19 pandemic.

作者信息

Mehta Jeet J, Patel Jaymin, Ayoub Bassam, Mohanty Bibhu D

机构信息

Division of Cardiology, Department of Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida.

出版信息

J Card Surg. 2020 Jun;35(6):1168-1169. doi: 10.1111/jocs.14602. Epub 2020 May 4.

Abstract

To improve resource allocation in face of the COVID-19 pandemic, hospitals around the country are restricting the performance of elective surgery to preserve ventilators, operating rooms, ICU beds and protect anesthesiologists. For patients with severe aortic stenosis, efforts to bring treatment to symptomatic patients amid this pandemic might lead to favored use of catheter based management using minimalist techniques that do not require these elements. In this context, some patients with well tested surgical indications for valve replacement may be treated by catheter-based methods. It is important that outcomes for these cases are followed closely both at respective sites and in national registries. As we recover from this pandemic, surgical cases should once again be driven by multi-disciplinary discussion and clinical trial data, and not a mentality of crisis management.

摘要

为了在新冠肺炎疫情期间优化资源分配,全国各地的医院都在限制择期手术的开展,以节省呼吸机、手术室、重症监护病床,并保护麻醉医生。对于重度主动脉瓣狭窄患者,在这场疫情中为有症状的患者提供治疗的努力可能会促使优先采用基于导管的管理方法,即使用不需要上述资源的极简技术。在这种情况下,一些具有经过充分验证的瓣膜置换手术指征的患者可能会接受基于导管的治疗方法。重要的是,要在各个医疗机构以及国家登记处密切跟踪这些病例的治疗结果。随着我们从这场疫情中恢复过来,手术病例的决策应再次由多学科讨论和临床试验数据驱动,而不是出于危机管理的心态。

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