How does preoperative SARS-CoV-2 time affect outcome parameters in open heart surgery?

Abstract

Aim: In the present study, the purpose was to compare the outcome parameters before open heart surgery according to the time of Covid-19 infection in patients who had Covid-19. The primary outcome was 28-day mortality, secondary outcomes were length of stay in the Intensive Care Unit, length of hospital stay, and postoperative complications. Material and Method: Patients, who were over the age of 18, who underwent open heart surgery between July 2021 and August 2022 in Izmir Katip Çelebi University Atatürk Training and Research Hospital Cardiovascular Surgery Clinic, were evaluated retrospectively. Those who had Covid-19 infection that was confirmed with the positivity of Polymerase Chain Reaction (PCR) before the surgery were included in the study. The patients were divided into 3 groups as those who underwent open heart surgery in the first 7 weeks following Covid-19, between 7-24 weeks and following 24 weeks. Patients who did not have preoperative Covid-19, those who underwent beating heart surgery, and patients who had postoperative Covid-19 were excluded from the study. Results: A total of 89 patients were evaluated. The mean age was 59.44±12.2 (23-81) years and 73% (n=58) patients were male. PCR positive-time to surgery was 33.72±25.86 (median 26.43) weeks. No difference was detected in terms of mortality and postoperative complications (bleeding, infection, acute neurological event, revision surgery, blood transfusion) among patients who underwent open heart surgery in the first 7 weeks, between 7-24 weeks and following 24 weeks following the Covid-19 infection. No difference was detected between the groups in terms of duration of anesthesia, duration of surgery, duration of cardiopulmonary bypass, and cross-clamping. It was found that extubation times, hospital stays, and length of stays on mechanical ventilator were higher in patients who underwent open heart surgery 7 to 24 weeks following Covid-19 infection (p= 0.02, p=0.05, p= 0.009). Conclusion: Although it was reported in the literature that surgery 7 weeks following Covid-19 infection is safe in terms of survival and morbidity, it was found in the present study that the duration of extubation, mechanical ventilation and hospital stays were prolonged in patients who were operated at a later period (up to the 24th week). We think that there is a need for further randomized controlled studies to evaluate the late effects of Covid-19 infection in open heart surgery.

Keywords

• open heart surgery
• post -covid 19
• timing of operation

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