Postoperative management of cardiac and vascular surgery in the period of COVID-19
- VernacularTitle:新型冠状病毒感染期行心脏大血管手术的术后管理
- Author:
Shuo CHANG
1
;
Xinyi ZHANG
2
;
Sheng HUANG
2
;
Yuxin FAN
2
;
Xiangbin PAN
3
;
Xiaoqi WANG
2
Author Information
1. Adult Surgery Center, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100037, P. R. China
2. Adult Surgery Center, Cardiovascular Hospital Affiliated to Kunming Medical University, Fuwai Cardiovascular Hospital, Kunming, 650102, P. R. China
3. Structural Heart Disease Center, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China
- Publication Type:Journal Article
- Keywords:
Novel coronavirus pneumonia;
coronavirus disease 2019;
cardiac and vascular surgery;
perioperation
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(07):967-973
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the postoperative characteristics and management experience of patients with coronavirus disease 2019 (COVID-19) undergoing cardiac and vascular surgery. Methods From December 7, 2022 to January 5, 2023, the patients with COVID-19 who were admitted to Cardiovascular Hospital Affiliated to Kunming Medical University and underwent cardiac and vascular surgery were selected. The clinical history, surgical information, postoperative recovery process and treatment plan were analyzed retrospectively. Results There were 18 patients in this group, including 11 (61.1%) males and 7 (38.9%) females, with an average age of 58.1±10.9 years. There were 7 patients of hypertension, 5 patients of diabetes, 3 patients of respiratory diseases, and 2 patient of chronic renal insufficiency. There were 5 (27.8%) patients receiving emergency operations and 13 (72.2%) elective operations. All the 18 patients underwent cardiac and vascular surgery in the period of COVID-19, and the time between the last positive nucleic acid test and the surgery was 1.50 (1.00, 6.25) days. There were 8 patients of pulmonary imaging changes, including 3 patients with chest patch shadow, 3 patients with thickened and disordered lung markings, and 2 patients with exudative changes before operation. Antiviral therapy was not adopted in all patients before operation. Three patients were complicated with viral pneumonia after operation, including 2 patients with high risk factors before operation, who developed into severe pneumonia after operation, and underwent tracheotomy. One patient with thrombus recovered after anticoagulation treatment. Another patient of mild pneumonia recovered after antiviral treatment. The other 15 patients recovered well without major complications. There was no operation-related death in the whole group. One patient died after surgery, with a mortality rate of 5.6%. Conclusion Patients with COVID-19 are at high risk of cardiac and vascular surgery, and patients with high-risk factors may rapidly progress to severe pneumonia. Patients with preoperative lung imaging changes or other basic visceral diseases should consider delaying the operation. Early antiviral combined with immunomodulation treatment for emergency surgery patients may help improve the prognosis.
