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Published in: Indian Journal of Thoracic and Cardiovascular Surgery 5/2020

01-09-2020 | Computed Tomography | Original Article

An Indian study: impact of COVID-19 on clinical decision-making and consensus in cardiac surgery practice across the country

Authors: Mohammed Idhrees, Chandrasekar Padmanabhan, Kuppan Jagadeesan, Bashi Velayudhan

Published in: Indian Journal of Thoracic and Cardiovascular Surgery | Issue 5/2020

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Abstract

Purpose

There is a paucity of evidence and guidelines to support clinical decisions in the present unprecedented time. We aimed to use the experience and consensus of the cardiac surgeons for clinical decisions until evidence-based guidelines are formed.

Methods

An electronic questionnaire was emailed to all the 1434 members of the Indian Association of Cardiovascular and Thoracic Surgery, starting from May 13, 2020, and the members were followed up with reminder emails. For a wider reach, social media like WhatsApp was also used to circulate the questionnaire. Participation was voluntary and anonymized. An effective consensus was considered when > 70% opted the same opinion, and moderate consensus when > 50% opted the same opinion.

Results

A total of 174 responses were obtained from the surgeons across the country. An effective consensus was obtained for the following: (i) emergency surgery in acute type A aortic dissection, (ii) urgent surgery in significant left main stem disease and mitral/aortic valves with pulmonary oedema, (iii) elective surgery in stable triple vessel disease and (iv) preoperative nasal swab examination for all patients undergoing surgery.

Conclusion

In the present era, where evidence is evolving and the country is entering a phase after lockdown, the surgeons face a dilemma in operating patients. These consensuses provide interim recommendation; still further evidence is published.
Literature
1.
go back to reference Thayyil J, Cherumanal JM. Issues of creating a new cadre of doctors for rural India. Int J Med Public Health. 2013;3(1):8–11. Thayyil J, Cherumanal JM. Issues of creating a new cadre of doctors for rural India. Int J Med Public Health. 2013;3(1):8–11.
9.
11.
go back to reference Majidi H, Niksolat F. Chest CT in patients suspected of COVID-19 infection: A reliable alternative for RT-PCR. Am J Emerg Med. 2020;S0735-6757(20):30244-8. Majidi H, Niksolat F. Chest CT in patients suspected of COVID-19 infection: A reliable alternative for RT-PCR. Am J Emerg Med. 2020;S0735-6757(20):30244-8.
12.
go back to reference Patel V, Jimenez E, Cornwell L, et al. Cardiac surgery during the Coronavirus Disease 2019 Pandemic: perioperative considerations and triage recommendations. J Am Heart Assoc. 2020;9:e017042. Patel V, Jimenez E, Cornwell L, et al. Cardiac surgery during the Coronavirus Disease 2019 Pandemic: perioperative considerations and triage recommendations. J Am Heart Assoc. 2020;9:e017042.
13.
go back to reference Al-Muharraqi MA. Testing recommendation for COVID-19 (SARS-CoV-2) in patients planned for surgery - continuing the service and 'suppressing' the pandemic. Br J Oral Maxillofac Surg. 2020;58:503-505. Al-Muharraqi MA. Testing recommendation for COVID-19 (SARS-CoV-2) in patients planned for surgery - continuing the service and 'suppressing' the pandemic. Br J Oral Maxillofac Surg. 2020;58:503-505.
14.
go back to reference Imai Y, Kuba K, Rao S, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature. 2005;436:112-116. Imai Y, Kuba K, Rao S, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature. 2005;436:112-116.
15.
go back to reference Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181:271-280.e8. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181:271-280.e8.
20.
go back to reference Awad WI, Idhrees M, Kennon S, Bashir M. Coronary artery bypass grafting surgery versus percutaneous coronary intervention: what is the clinical decision framework amid COVID-19 era? [published online ahead of print, 2020 Jul 11]. J Card Surg. 2020. https://doi.org/10.1111/jocs.14833. Awad WI, Idhrees M, Kennon S, Bashir M. Coronary artery bypass grafting surgery versus percutaneous coronary intervention: what is the clinical decision framework amid COVID-19 era? [published online ahead of print, 2020 Jul 11]. J Card Surg. 2020. https://​doi.​org/​10.​1111/​jocs.​14833.
21.
go back to reference https://www.pcronline.com/News/Whats-new-on-PCRonline/2020/Cardiac-Surgery-and-the-COVID-19-outbreak-what-does-it-mean. Accessed June 1st, 2020 https://www.pcronline.com/News/Whats-new-on-PCRonline/2020/Cardiac-Surgery-and-the-COVID-19-outbreak-what-does-it-mean. Accessed June 1st, 2020
Metadata
Title
An Indian study: impact of COVID-19 on clinical decision-making and consensus in cardiac surgery practice across the country
Authors
Mohammed Idhrees
Chandrasekar Padmanabhan
Kuppan Jagadeesan
Bashi Velayudhan
Publication date
01-09-2020
Publisher
Springer Singapore
Published in
Indian Journal of Thoracic and Cardiovascular Surgery / Issue 5/2020
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI
https://doi.org/10.1007/s12055-020-01022-y

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