Adult Cardiac Surgery During Covid-19 Lockdown: Impact On Activity And Outcomes In A High-Volume Centre

Background. & mdash; The coronavirus disease 2019 (COVID-19) outbreak had a direct impact on adult cardiac surgery activity, which systematically necessitates a postoperative stay in intensive care. Aim. & mdash; To study the effect of the COVID-19 lockdown on cardiac surgery activity and outcomes, by making a comparison with the corresponding period in 2019. Methods. & mdash; This prospective observational cohort study compared adult cardiac surgery activity in our high-volume referral university hospital from 9 March to 10 May 2020 versus 9 March to 10 May 2019. Data were collected in our local certified database and a national database sponsored by the French society of thoracic and cardiovascular surgery. The primary study endpoints were operative mortality and postoperative complications. Results. & mdash; With 105 interventions in 2020, our activity dropped by 57% compared with the same period in 2019. Patients were at higher risk, with a significantly higher EuroSCORE II score (3.8 + 4.5% vs. 2.0 + 1.8%; P < 0.001) and higher rates of active endocarditis (7.6% vs. 2.9%; P= 0.047) and recent myocardial infarction (9.5% vs. 0%; P < 0.001). The weight and priority of the interventions were significantly different in 2020 (P = 0.019 and P < 0.001, respectively). The rate of acute aortic syndromes was also significantly higher in 2020 (P < 0.001). Operative mortality was higher during the lockdown period (5.7% vs. 1.7%; P= 0.038). The postoperative course was more complicated in 2020, with more postoperative bleeding (P= 0.003), mechan-ical circulatory support (P= 0.032) and prolonged mechanical ventilation (P= 0.005). Only two patients (1.8%) developed a positive status for severe acute respiratory syndrome coronavirus 2 after discharge. Conclusions. & mdash; Adult cardiac surgery was heavily affected by the COVID-19 lockdown. A further modulation plan is necessary to improve outcomes and reduce postponed operations to decrease operative mortality and morbidity. (c) 2021 Elsevier Masson SAS. All rights reserved.