Providing Safe Perioperative Care in Cardiac Surgery during the COVID-19 Pandemic

Mihalj, Maks; Mosbahi, Selim; Schmidli, Juerg; Heinisch, Paul Philipp; Reineke, David; Schoenhoff, Florian; Kadner, Alexander; Schefold, Joerg C.; Räber, Lorenz; Potapov, Evgenij V.; Luedi, Markus M.

The coronavirus disease 2019 (COVID-19) pandemic has potentiated the need for implementation of strict safety measures in the medical care of surgical patients – and especially in cardiac surgery patients, who are at higher risk of COVID-19-associated morbidity and mortality. Such measures not only require minimization of patients’ exposure to COVID-19 but also careful balancing of the risks of postponing non-emergent surgical procedures and providing appropriate and timely surgical care. We provide an overview of current evidence for preoperative strategies used in cardiac surgery patients, including risk stratification, telemedicine, logistical challenges during inpatient care, appropriate screening capacity, and decision-making about when to safely operate on COVID-19 patients. Further, we focus on perioperative measures such as safe operating room management and address the dilemma over when to perform cardiovascular surgical procedures in patients at risk.