KOCHI: Covid mortality rate of patients who have undergone a cardiac surgery is close to 25%, shows a study from Kerala.
Undertaken to understand the early outcomes of patients who underwent cardiac surgery and developed Covid during the inhospital admission period, the study parallels the mortality data furnished by larger studies from the UK pertaining to cardiac surgery.
"Perioperative Covid infection could potentially render cardiac surgery patients fatally vulnerable. Our survey data shows one in four mortality in patients developing Covid infection in patients undergoing cardiac surgery. The bottom line is rigorous pre-operative screening for Covid infection in cardiac surgical patients to improve surgical outcomes in this subset," said Dr Praveen K Varman, department of Cardiothoracic Surgery, Amrita Institute of Medical Sciences, Kochi, who is part of the study.
For the study, an anonymous survey questionnaire comprising 13 questions designed to collect outcome data of cardiac surgical procedures in both adult and paediatric patients was prepared. Responses of 330 patients who were reported to have documented perioperative Covid were studied and it was found that the main cause of mortality was respiratory issues followed by multi-organ dysfunction syndrome, while cardiac- and cardiac surgery–related causes leading to death was as low as 6 %.
“The effect of Covid vaccination on cardiac surgical outcomes needs to be further studied as the survey was conducted in a prevaccination cohort. But we believe that it is time for us as a fraternity to introspect and adapt to the changing practice environment, furthered by research and revision of guidelines," added Dr Praveen.
Covid- 19 pandemic has resulted in global disruption of cardiac surgical practices. Though the Indian Association of Cardio-Thoracic Surgeons (IACTS) has provided the framework for pre-operative workup, case selection protocols, and Covid-positive triage systems to support cardiac surgical practice in India, the study lays emphasis on the need to perform outcome analyses of the surgical results to synthesize new protocols and modify the existing ones.
"The whole effort is to ensure that a patient doesn't develop Covid either at hospital or home post-surgery. After discharge, patients are advised to isolate themselves at home for a few days," said Dr Baiju S Dharan, head, cardiovascular & thoracic surgery department, Sree Chithra institute for Medical sciences & Technology, Thiruvananthapuram. They had four patients-- three adults and one paediatric patient-- of which they lost one adult patient due to respiratory complications of Covid.
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