The Impact of COVID-19 on the Provision of Adult Cardiac Surgery at a Dedicated COVID Hospital in Australia

Objective We report the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiac surgery trainee education in North America. Methods A survey was sent to participating academic adult cardiac surgery centers in North America. Data regarding the effect of COVID-19 on cardiac surgery training were analyzed. Results Responses were received from 53 academic institutions with diverse geographic distribution. Cardiac surgery trainee re-deployment to alternative clinical duties peaked at the height of the pandemic. We stratified institutions based on high ( n = 20) and low burden ( n = 33) of patients hospitalized with COVID-19. The majority of institutions have converted didactics (high burden 90% vs low burden 73%) and interviews for jobs/fellowships (high burden 75% vs low burden 73%) from in-person to virtual. Institutions were mixed in preference for administration of the licensing examination, with the most common preference for examinations to be held remotely on normal timeline (high burden 45% vs low burden 30%) or in person with more than 3-month delay (high burden 20% vs low burden 33%). Despite the challenges experienced during the COVID-19 pandemic on trainee clinical experience, re-deployment, and decreased operative volume, institutions expected their trainees to graduate on schedule (high burden 95% vs low burden 91%). Conclusions Our study demonstrates that actions taken during the COVID-19 pandemic has led to disruptions in cardiac surgery training with transition of didactics and interviews virtually and re-deployment to alternative duties. Despite this, institutions remain optimistic that their trainees will graduate on schedule.

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The impact of hyperlactatemia on postoperative outcome after adult cardiac surgery

Journal of Anesthesia ◽

10.1007/s00540-011-1287-0 ◽

2011 ◽

Vol 26 (2) ◽

pp. 174-178 ◽

Cited By ~ 34

Author(s):

Alexander Kogan ◽

Sergey Preisman ◽

Alex Bar ◽

Leonid Sternik ◽

Jacob Lavee ◽

...

Keyword(s):

Cardiac Surgery ◽

Postoperative Outcome ◽

The Impact ◽

Adult Cardiac Surgery

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The Impact of Preoperative Frailty on the Clinical and Cost Outcomes of Adult Cardiac Surgery in Alberta, Canada: A Cohort Study

CJC Open ◽

10.1016/j.cjco.2020.09.009 ◽

2020 ◽

Author(s):

Carmel L. Montgomery ◽

Nguyen X. Thanh ◽

Henry T. Stelfox ◽

Colleen M. Norris ◽

Darryl B. Rolfson ◽

...

Keyword(s):

Cardiac Surgery ◽

Cohort Study ◽

The Impact ◽

Cost Outcomes ◽

Adult Cardiac Surgery

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Improved Outcomes With Integrated Intensivist Consultation for Cardiac Surgery Patients

American Journal of Medical Quality ◽

10.1177/1062860618766614 ◽

2018 ◽

Vol 33 (6) ◽

pp. 576-582 ◽

Cited By ~ 3

Author(s):

Omer W. Sultan ◽

Lori L. Boland ◽

Tyler G. Kinzy ◽

Roman R. Melamed ◽

Susan C. Seatter ◽

...

Keyword(s):

Cardiac Surgery ◽

Retrospective Cohort ◽

Care Center ◽

Risk Of Mortality ◽

Improved Outcomes ◽

Time Periods ◽

The Impact ◽

Predicted Risk ◽

Adult Cardiac Surgery ◽

Ventilator Time

This study examined the impact of integrated intensivist consultation in the immediate postoperative period on outcomes for cardiac surgery patients. A retrospective cohort study was conducted in 1711 adult cardiac surgery patients from a single quaternary care center in Minnesota. Outcomes were compared across 2 consecutive 2-year time periods reflecting an elective intensivist model (n = 801) and an integrated intensivist model (n = 910). Patients under the 2 models were comparable with respect to demographics, comorbidities, procedure types, and Society for Thoracic Surgery predicted risk of mortality score; however, patients in the earlier cohort were slightly older and more likely to have chronic kidney disease ( P = .003). Integrated intensivist involvement was associated with reduced postoperative ventilator time, length of stay (LOS), stroke, encephalopathy, and reoperations for bleeding (all P < .01) but was not associated with mortality. Intensivist integration into the postoperative care of cardiac surgery patients may reduce ventilator time, LOS, and complications but may not improve survival.

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Intraoperative Transoesophageal Echocardiography: Impact on Adult Cardiac Surgery

Anaesthesia and Intensive Care ◽

10.1177/0310057x9802600310 ◽

1998 ◽

Vol 26 (3) ◽

pp. 287-293 ◽

Cited By ~ 31

Author(s):

D. C. Sutton ◽

R. Kluger

Keyword(s):

Cardiac Surgery ◽

Prospective Observational Study ◽

Case Reports ◽

Transoesophageal Echocardiography ◽

Surgical Patients ◽

Cardiac Pathology ◽

Therapeutic Implications ◽

Multiple Case ◽

The Impact ◽

Adult Cardiac Surgery

Although multiple case reports have demonstrated the capability of transoesophageal echocardiography (TOE) to detect unsuspected cardiac pathology with important therapeutic implications, few studies have examined the effect of real-time interpretation of routine TOE on clinical management of a typical series of cardiac surgery patients. To assess the impact of intraoperative TOE on cardiac surgical management, we conducted a prospective observational study on 238 consecutive patients undergoing intraoperative TOE during adult cardiac surgery. Potentially important new diagnostic information was detected in 39 of 184 (21%) routine and in 53 of 54 requested TOE examinations, and led directly to different surgical procedures in 11 of 184 (6%) routine and in 12 of 54 (22%) requested TOE examinations. Our data suggests that intraoperative TOE may be a valuable tool in the routine management of adult cardiac surgical patients.

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