Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
Ann Thorac Surg. 2020 Oct;110(4):1108-1118. doi: 10.1016/j.athoracsur.2020.04.012. Epub 2020 Jun 23.
The onset of the coronavirus disease 2019 (COVID-19) pandemic has forced our cardiac surgery program and hospital to enact drastic measures that has forced us to change how we care for cardiac surgery patients, assist with COVID-19 care, and enable support for the hospital in terms of physical resources, providers, and resident training.
In this review, we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic, including the use of telemedicine, how a severe reduction in operative volume affected our program, the process of redeployment of staff, repurposing of residents into specific task teams, the creation of operation room intensive care units, and the challenges that we faced in this process.
We offer a revised set of definitions of surgical priority during this pandemic and how this was applied to our system, followed by specific considerations in coronary/valve, aortic, heart failure and transplant surgery. Finally, we outline a path forward for cardiac surgery for the near future.
We recognize that individual programs around the world will eventually face COVID-19 with varying levels of infection burden and different resources, and we hope this document can assist programs to plan for the future.
2019 年冠状病毒病（COVID-19）大流行的爆发迫使我们的心脏外科项目和医院采取了严厉措施，这迫使我们改变了对心脏外科患者的护理方式，协助 COVID-19 的护理，并在物力、医护人员和住院医师培训方面为医院提供支持。
在这篇综述中，我们回顾了 COVID-19 的心血管表现，并描述了我们对大流行的系统级适应措施，包括远程医疗的使用、手术量严重减少如何影响我们的项目、人员重新部署的过程、住院医师重新分配到特定任务小组、创建手术室重症监护病房，以及我们在这一过程中面临的挑战。
我们提出了一套在大流行期间进行手术的优先级的新定义，并介绍了如何在我们的系统中应用这些定义，随后介绍了在冠状动脉/瓣膜、主动脉、心力衰竭和心脏移植手术方面的具体考虑因素。最后，我们为心脏外科的近期发展勾勒出一条前进的道路。
我们认识到，世界各地的个别项目最终将面临不同程度的感染负担和不同资源的 COVID-19，我们希望本文件能帮助项目为未来做好规划。
