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The fate of patients with acute aortic syndrome during the coronavirus (COVID-19)
pandemic: A UK multicenter study
#MMPMID34172983
Lopez-Marco A
; Rosser B
; Harky A
; Verdichizzo D
; McPherson I
; Hope E
; Qadri S
; Oo A
JTCVS Open
2021[Mar]; 5
(?): 17-25
PMID34172983
show ga
OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has posed challenges
to health care services across the world. There has been a significant
restructuring of health care resources to protect services for patients with
COVID-19-related illness and to maintain emergency and urgent medical and
surgical activity. This study assessed access to emergency treatment, logistical
challenges, and outcomes of patients with acute aortic syndrome during the early
months of the COVID-19 pandemic in the United Kingdom. METHODS: This was a
multicenter study, from March 1 to May 20, 2020 that included 19 cardiac centers,
was a retrospective analysis of prospectively collected data obtained from
individual centers' national cardiac surgical databases. Demographic details,
choice of treatment, operative details, and outcomes were collected. COVID-19
screening, timing of surgery, and outcomes of COVID-19-positive and -negative
patients were also analyzed. RESULTS: In total, 88 patients presented with acute
aortic syndrome to participating centers from March 1 to May 20, 2020. There were
79 aortic dissections (89.8%), 7 intramural hematomas (7.9%), and 2 penetrating
aortic ulcers (2.3%). Seventy-nine patients (89.8%) underwent surgery.
In-hospital mortality was 25.3% (n = 20). Postoperative complications included
13.9% postoperative stroke (11.4% permanent and 2.3% temporary), 16.5% rate of
hemofiltration, and 10.1% rate of tracheostomy. Nine patients were treated
conservatively with a mortality of 60%. Seven patients were diagnosed with
COVID-19, and there was no associated mortality. CONCLUSIONS: Despite extensive
restructuring of health care resources, access to emergency and urgent treatment
for patients with acute aortic syndrome was maintained in the early months of the
COVID-19 pandemic in the United Kingdom. Clinical outcomes were similar to the
prepandemic period.
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