CARDIAC SURGERY
Despite the administrative and logistic difficulties to establish real
cooperation between private and public hospitals, the realization of the
hub-spoke network had been successful. Reorganizing human and logistic
resources took a few days. Nevertheless, all the patients had always
found a hospital ready to treat their urgent and emergent pathology
regardless of their admittance origin. Furthermore, real cooperation
between core and referral centers, difficult to believe since a couple a
months ago, has permitted to evaluate and treat also patients with a not
deferrable disease, avoiding the worsening of their clinical conditions.
In case of not transferrable emergencies, the presence of an on-call
team in the spoke center seemed to be useful as happened in five cardiac
surgery cases during the analyzed period.
Preoperative COVID screening and subsequent hospital areas and pathways
separation has permitted to guarantee patients’ safety. No one of the
treated cases admitted as COVID-free became later infected,
demonstrating substantial adequacy of our safety measure applied.
A further demonstration of efficacy and safety of the hub role is
represented by the zero in-hospital mortality achieved in the first
30-days of our cardiac surgery activity. This is absolutely comparable
with the high standard results of the previous years. Non-COVID patients
can be treated with no adjunctive risks if all the safety protocols to
separate pathways and areas are applied 11Bonalumi G, Di Mauro
M, Garatti A, Barili F, Gerosa G, Parolari A; Italian Society for
Cardiac Surgery Task Force on COVID-19 Pandemic. The COVID-19 outbreak
and its impact on hospitals in Italy: the model of cardiac surgery.
Eur J Cardiothorac Surg. 2020 Apr 17. pii: ezaa151. doi:
10.1093/ejcts/ezaa151. [Epub ahead of print] No abstract
available. PMID:32301984. In cardiac surgery, we showed an important
reduction of urgent cases compared to the same period in 2019 in the
same area. This impression is confirmed by the data published by others
about acute coronary syndromes and cardiovascular pathologies diagnosis
during the sars-cov19 pandemic 22Metzler B, Siostrzonek P,
Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome
admissions in Austria since the outbreak of COVID-19: the pandemic
response causes cardiac collateral damage [published online ahead of
print, 2020 Apr 16]. Eur Heart J. 2020;ehaa314,33Tam
CF, Cheung KS, Lam S, et al. Impact of Coronavirus Disease 2019
(COVID-19) Outbreak on ST-Segment-Elevation Myocardial Infarction Care
in Hong Kong, China. Circ Cardiovasc Qual Outcomes.
2020;13(4):e006631. doi:10.1161/CIRCOUTCOMES.120.006631,44Garcia
S, Albaghdadi MS, Meraj PM, et al. Reduction in ST-Segment Elevation
Cardiac Catheterization Laboratory Activations in the United States
during COVID-19 Pandemic [published online ahead of print, 2020 Apr
9]. J Am Coll Cardiol. 2020;S0735-1097(20)34913-5,55Rodríguez-Leor
O, et al. Impacto de la pandemia de COVID-19 sobre la actividad
asistencial en cardiología ntervencionista en España. REC Interv
Cardiol.2020. doi:10.24875/RECIC.M20000120