The fate of patients with acute aortic syndrome during the coronavirus (COVID-19) pandemic: A UK multicenter studyCentral MessagePerspective

• Published in: JTCVS open Vol. 5; pp. 17 - 25
• Main Authors: Ana Lopez-Marco, PhD, Barbara Rosser, MD, Amer Harky, MD, Danilo Verdichizzo, MD, Iain McPherson, MD, Emma Hope, RN, Syed Qadri, MD, Aung Oo, MD, Aung Oo, Geoffrey Tsang, Alex Cale, Jorge Mascaro, Mark Field, Manoj Kuduvalli, Giovanni Mariscalco, Jon Anderson, Sunil Bhudia, Ulrich Rosendahl, Jonathan Hyde, George Krasopoulos, Stefano Forlani, Karen Booth, Uday Dandekar, Kelvin Lim, Reuben Jeganathan, Nidal Bittar, Mazyar Kanani, Hussein El-Shafei, L. Balacumaraswani
• Format: Journal Article
• Language: English
• Published: Elsevier 01.03.2021
• Subjects: acute aortic syndromes; aorta; COVID-19 pandemic; emergency surgery
• ISSN: 2666-2736; 2666-2736

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.