Short-term clinical outcomes of adult cardiac surgery in patients with prior COVID-19 in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

QIN Haokai ¹ , XIE Enzehua ² , ZHOU Xiaozheng ¹ , PENG Zhan ¹ , HUA Kun ¹ ,  YANG Xiubin ¹

1. Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, P. R. China;
2. Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China;

Corresponding author：

YANG Xiubin, Email: xiubinyang@yahoo.com

Keywords：

COVID-19; adult cardiac surgery; perioperative period; short-term outcomes

DOI：

10.7507/1007-4848.202301036

Video：

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Objective To provide experience for clinical diagnosis and treatment through exploring the perioperative characteristics and short-term treatment outcomes of adult cardiac surgery in patients with prior coronavirus disease-2019 (COVID-19). Methods A retrospective analysis was performed on patients undergoing coronary artery bypass grafting (CABG) or valve surgery in the Department of Cardiac Surgery of Beijing Anzhen Hospital from December 26, 2022 to December 31, 2022, and previously diagnosed with COVID-19 before surgery. Results Finally 108 patients were collected, including 81 males and 27 females, with an average age of 60.73±8.66 years. Two (1.9%) patients received emergency surgery, and the others received elective surgery. The 86.1% of patients had been vaccinated, and the duration of COVID-19 was 5.0 (4.0, 7.0) days. The time from COVID-19 to operation was 15.0 (12.0, 17.8) days. Eighty-nine patients received CABG, of which off-pump CABG was dominant (92.1%). Nineteen patients received valve surgery. The rate of delayed extubation of ventilator was 17.6%. The ICU stay was 21.0 (17.3, 24.0) hours, and the postoperative hospital stay was 7.0 (6.0, 8.0) days. Three (2.8%) patients were treated with intra-aortic balloon pump (IABP), one (0.9%) patient was treated with extracorporeal membrane oxygenation (ECMO), one (0.9%) patient was treated with continuous renal replacement therapy (CRRT) due to acute renal insufficiency, three (2.8%) patients were treated with temporary pacemaker, and one (0.9%) patient underwent rethoracotomy. In terms of postoperative complications, the incidence of cerebrovascular accident, acute renal insufficiency, gastrointestinal bleeding and septicemia was 0.9%, respectively, and the incidence of acute heart failure, lung infection, and liver insufficiency was 1.9%, respectively. All patients recovered and were discharged from hospital, and no in-hospital death occurred. Conclusion The utilization rate of postoperative IABP, ECMO, CRRT, temporary pacemaker and the incidence of serious complications in patients with prior COVID-19 are not higher than those of normal patients, and the short-term treatment outcome is good.

Citation： QIN Haokai, XIE Enzehua, ZHOU Xiaozheng, PENG Zhan, HUA Kun, YANG Xiubin. Short-term clinical outcomes of adult cardiac surgery in patients with prior COVID-19 in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(7): 956-961. doi: 10.7507/1007-4848.202301036 Copy

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13.	中国生物医学工程学会体外循环分会. 2021年中国心外科手术和体外循环数据白皮书. 中国体外循环杂志, 2022, 20(4): 196-199.
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1. 关于印发对新型冠状病毒感染实施“乙类乙管”总体方案的通知. http://www.nhc.gov.cn/xcs/zhengcwj/202212/e97e4c449d7a475794624b8ea12123c6.shtml. Accessed on 2023-1-19.
2. 廖春晓, 王波, 吕筠, 等. 新型冠状病毒Omicron变异株病原学及流行病学研究进展. 中华流行病学杂志, 2022, 43(11): 1691-1698.
3. 中华人民共和国国家卫生健康委员会. 新型冠状病毒感染诊疗方案(试行第十版). 中华临床感染病杂志, 2023, 16(1): 1-9.
4. WHO Coronavirus (COVID-19) Dashboard. WHO Coronavirus (COVID-19) Dashboard with vaccination data. https://covid19.who.int/?gclid. Accessed on 2023-1-19.
5. 中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2021概要. 中国循环杂志, 2022, 37(6): 553-578.
6. Zheng YY, Ma YT, Zhang JY, et al. COVID-19 and the cardiovascular system. Nat Rev Cardiol, 2020, 17(5): 259-260.
7. Mitrani RD, Dabas N, Goldberger JJ. COVID-19 cardiac injury: Implications for long-term surveillance and outcomes in survivors. Heart Rhythm, 2020, 17(11): 1984-1990.
8. Huang L, Zhao P, Tang D, et al. Cardiac involvement in patients recovered from COVID-2019 identified using magnetic resonance imaging. JACC Cardiovasc Imaging, 2020, 13(11): 2330-2339.
9. Deng JZ, Chan JS, Potter AL, et al. The risk of postoperative complications after major elective surgery in active or resolved COVID-19 in the United States. Ann Surg, 2022, 275(2): 242-246.
10. Nguyen TC, Thourani VH, Nissen AP, et al. The effect of COVID-19 on adult cardiac surgery in the United States in 717 103 patients. Ann Thorac Surg, 2022, 113(3): 738-746.
11. Shuai H, Chan JF, Hu B, et al. Attenuated replication and pathogenicity of SARS-CoV-2 B. 1. 1. 529 Omicron. Nature, 2022, 603(7902): 693-699.
12. Zaky SS, Hanna AH, Sakr Esa WA, et al. An 11-year, single-institution analysis of intra-aortic balloon pump use in cardiac surgery. J Cardiothorac Vasc Anesth, 2009, 23(4): 479-483.
13. 中国生物医学工程学会体外循环分会. 2021年中国心外科手术和体外循环数据白皮书. 中国体外循环杂志, 2022, 20(4): 196-199.
14. Thiele RH, Isbell JM, Rosner MH. AKI associated with cardiac surgery. Clin J Am Soc Nephrol, 2015, 10(3): 500-514.
15. Gaudino M, Rahouma M, Di Mauro M, et al. Early versus delayed stroke after cardiac surgery: A systematic review and meta-analysis. J Am Heart Assoc, 2019, 8(13): e012447.
16. Wang Y, Bellomo R. Cardiac surgery-associated acute kidney injury: Risk factors, pathophysiology and treatment. Nat Rev Nephrol, 2017, 13(11): 697-711.
17. Massart N, Mansour A, Ross JT, et al. Mortality due to hospital-acquired infection after cardiac surgery. J Thorac Cardiovasc Surg, 2022, 163(6): 2131-2140.
18. Schoonen A, van Klei WA, van Wolfswinkel L, et al. Definitions of low cardiac output syndrome after cardiac surgery and their effect on the incidence of intraoperative LCOS: A literature review and cohort study. Front Cardiovasc Med, 2022, 9: 926957.
19. 陈艳玲, 陈光献, 曾讯, 等. 心脏手术后消化道并发症的原因分析. 中华普通外科学文献(电子版), 2011, 5(5): 441-443.
20. Farag M, Veres G, Szabó G, et al. Hyperbilirubinaemia after cardiac surgery: The point of no return. ESC Heart Fail, 2019, 6(4): 694-700.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Short-term clinical outcomes of adult cardiac surgery in patients with prior COVID-19 in a single center

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