Adult Cardiac Surgery During Covid-19 Pandemic

Gerardo AK Laksono, Andreas MS Hutama, Paul L Tahalele


Coronavirus Disease 2019 (COVID-19), which is caused by the SARS Coronavirus 2
(SARS-CoV-2), has affected over 200 countries worldwide. First case of COVID-19 was
found in Wuhan, China, precisely around December 2019. COVID-19, especially in those
with underlying health conditions or comorbidities, has an increasingly rapid and severe
progression, often leading to death. This virus is a single-strand RNA coronavirus, binding the angiotensin-converting enzyme 2 (ACE2) receptor which enters human cells. Coronavirus
disease has been reported to affect cardiac and vascular organs. cardiomyocyte death and
inflammation are results of a direct mechanism that involves viral infiltration into myocardial
tissue. Some cardiovascular manifestations of myocardial injuries associated with COVID-19
are arrhythmias, myocardial infarction, heart failure, and elevated biomarkers (cardiac
troponin I and brain-type natriuretic peptide). Some of this manifestation requires immediate intervention or surgery. Criteria are needed for hospitals or institutions that mostly maintain cardiac surgery services and surgery-urgent patients depending on severity of the disease and hospital resources. These criteria also limit the risk of exposure to patients and healthcare workers and allocate resources appropriately to those in greatest need. This paper aims to share our discussion and give an overview of patients undergoing cardiac surgery, providing clinicians with recommendations to triage and plan these procedures during the COVID-19 outbreak effectively.

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Cardiovascular; adult cardiac surgery; covid-19

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