Cardiac surgery practice during the COVID-19 outbreak: a multicentre national survey
Authors: Rubino Antonino Salvatore , De Santo Luca Salvatore , Pisano Antonio , Mauro Michele di , Benussi Stefano , Borghetti Valentino , Castiglioni Alessandro , Chiariello Luigi , Colli Andrea , De Bellis Antonio , De Filippo Carlo Maria , De Paulis Ruggero , Di Benedetto Giuseppe , Di Eusanio Marco , Faggian Giuseppe , Fiorani Brenno , Fratto Pasquale Antonio , Giuffrida Angelo Giuseppe , Glauber Mattia , Iannelli Gabriele , Iesu Severino , Livi Ugolino , Martinelli Gianluca , Massetti Massimo , Mastroroberto Pasquale , Menicanti Lorenzo , Minniti Giuseppe , Miraldi Fabio , Montesi Gianfranco , Musumeci Francesco , Nicolini Francesco , Napoleone Carlo Pace , Panisi Paolo , Pappalardo Aniello , Patanè Francesco , Ragni Temistocle , Rinaldi Mauro , Tribastone Salvatore , Triggiani Michele , Tritto Francesco Paolo , Zebele Carlo , Parolari Alessandro , Gerosa Gino , De Feo Marisa ,   for the Italian Society for Cardiac Surgery Task Force on COVID-19 Pandemic, Antonino Salvatore Rubino , Luca Salvatore De Santo , Antonio Pisano , Michele di Mauro , Stefano Benussi , Valentino Borghetti , Alessandro Castiglioni , Luigi Chiariello , Andrea Colli , Antonio De Bellis , Carlo Maria De Filippo , Ruggero De Paulis , Giuseppe Di Benedetto , Marco Di Eusanio , Giuseppe Faggian , Brenno Fiorani , Pasquale Antonio Fratto , Angelo Giuseppe Giuffrida , Mattia Glauber , Gabriele Iannelli , Severino Iesu , Ugolino Livi , Gianluca Martinelli , Massimo Massetti , Pasquale Mastroroberto , Lorenzo Menicanti , Giuseppe Minniti , Fabio Miraldi , Gianfranco Montesi , Francesco Musumeci , Francesco Nicolini , Carlo Pace Napoleone , Paolo Panisi , Aniello Pappalardo , Francesco Patanè , Temistocle Ragni , Mauro Rinaldi , Salvatore Tribastone , Michele Triggiani , Francesco Paolo Tritto , Carlo Zebele , Alessandro Parolari , Gino Gerosa , Marisa De Feo 
Published: January 2021

OBJECTIVES

Healthcare systems worldwide have been overburdened by the coronavirus disease 2019 (COVID-19) outbreak. Accordingly, hospitals had to implement strategies to profoundly reshape both non-COVID-19 medical care and surgical activities. Knowledge about the impact of the COVID-19 pandemic on cardiac surgery practice is pivotal. The goal of the present study was to describe the changes in cardiac surgery practices during the health emergency at the national level.

METHODS

A 26-question web-enabled survey including all adult cardiac surgery units in Italy was conducted to assess how their clinical practice changed during the national lockdown. Data were compared to data from the corresponding period in 2019.

RESULTS

All but 2 centres (94.9%) adopted specific protocols to screen patients and personnel. A significant reduction in the number of dedicated cardiac intensive care unit beds (−35.4%) and operating rooms (−29.2%), along with healthcare personnel reallocation to COVID departments (nurses −15.4%, anaesthesiologists −7.7%), was noted. Overall adult cardiac surgery volumes were dramatically reduced (1734 procedures vs 3447; P &lt; 0.001), with a significant drop in elective procedures [580 (33.4%) vs 2420 (70.2%)].

CONCLUSIONS

This national survey found major changes in cardiac surgery practice as a response to the COVID-19 pandemic. This experience should lead to the development of permanent systems-based plans to face possible future pandemics. These data may effectively help policy decision-making in prioritizing healthcare resource reallocation during the ongoing pandemic and once the healthcare emergency is over.