Perioperative results of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Xiaochen ¹ , SUN Hailei ¹ , ZHANG Chaoyu ² , ZHOU Zhengchun ¹ , WEI Yu ¹ , XUAN Haiyang ¹ , CHENG Guangcun ¹ ,  GE Jianjun ¹

1. Department of Cardiovascular Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230000, P. R. China;
2. Anhui Medical University, Hefei, 230000, P. R. China;

Corresponding author：

GE Jianjun, Email: slgejianjun@outlook.com

Keywords：

SARS-CoV-2; asymptomatic infection; cardiac valve surgery; perioperative period

DOI：

10.7507/1007-4848.202304025

Video：

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Objective To analyze the perioperative outcomes of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection. Methods The perioperative clinical data of patients receiving heart valve replacement in the Department of Cardiovascular Surgery, the First Affiliated Hospital of University of Science and Technology of China from November 2022 to February 2023 were retrospectively analyzed. According to whether the patients were infected with SARS-CoV-2, they were divided into a non-infected group and an asymptomatic group. The perioperative data of the patients were compared between the two groups, and the effect of asymptomatic infection on the result of heart valve replacement surgery was analyzed. Results A total of 66 patients were enrolled including 36 males and 30 females with a mean age of 58.0±11.1 years. There were 51 patients in the non-infected group and 15 patients in the asymtomatic group. There were 2 patients of mitral valve replacement, 20 patients of aortic valve replacement, 1 patient of double valve replacement, 3 patients of aortic valve replacement with tricuspid valvoplasty, 22 patients of mitral valve replacement and tricuspid valvoplasty, 18 patients of double valve replacement and tricuspid valvoplasty. Asymptomatic infected patients received more emergency surgery than uninfected patients (26.7% vs. 0.0%, P<0.01). There was no statistical difference in the duration of extracorporeal circulation, aortic occlusion, mechanical ventilation time after the surgery, ICU stay, postoperative drainage volume, or postoperative complications between the two groups. Conclusion Perioperative results of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection and non-infection are almost the same.

Citation： WANG Xiaochen, SUN Hailei, ZHANG Chaoyu, ZHOU Zhengchun, WEI Yu, XUAN Haiyang, CHENG Guangcun, GE Jianjun. Perioperative results of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(7): 962-966. doi: 10.7507/1007-4848.202304025 Copy

1.	朱家德, 郭惠明. 新冠疫情下的心脏外科: 改变与应对之策. 中国胸心血管外科临床杂志, 2023, 30(2): 162-166.
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6.	Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol, 2020, 5(7): 802-810.
7.	Nguyen TC, Thourani VH, Nissen AP, et al. The effect of COVID-19 on adult cardiac surgery in the United States in 717 103 patients. Ann Thorac Surg, 2022, 113(3): 738-746.
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11.	Lieberman N, Racine A, Nair S, et al. Should asymptomatic patients testing positive for SARS-CoV-2 wait for elective surgical procedures? Br J Anaesth, 2022, 128(5): e311-e314.
12.	Benedetto U, Goodwin A, Kendall S, et al. A nationwide survey of UK cardiac surgeons' view on clinical decision making during the coronavirus disease 2019 (COVID-19) pandemic. J Thorac Cardiovasc Surg, 2020, 160(4): 968-973.
13.	Yang Y, Wang Z, Chen Z, et al. Current status and etiology of valvular heart disease in China: A population-based survey. BMC Cardiovasc Disord, 2021, 21(1): 339.
14.	COVIDSurg Collaborative. Outcomes and their state-level variation in patients undergoing surgery with perioperative SARS-CoV-2 infection in the USA: A prospective multicenter study. Ann Surg, 2022, 275(2): 247-251.
15.	COVIDSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: An international prospective cohort study. Anaesthesia, 2021, 76(6): 748-758.
16.	Deng JZ, Chan JS, Potter AL, et al. The risk of postoperative complications after major elective surgery in active or resolved COVID-19 in the United States. Ann Surg, 2022, 275(2): 242-246.
17.	Nahshon C, Bitterman A, Haddad R, et al. Hazardous postoperative outcomes of unexpected COVID-19 infected patients: A call for global consideration of sampling all asymptomatic patients before surgical treatment. World J Surg, 2020, 44(8): 2477-2481.
18.	Bryant JM, Boncyk CS, Rengel KF, et al. Association of time to surgery after COVID-19 infection with risk of postoperative cardiovascular morbidity. JAMA Netw Open, 2022, 5(12): e2246922.
19.	Prasad NK, Lake R, Englum BR, et al. COVID-19 vaccination associated with reduced postoperative SARS-CoV-2 infection and morbidity. Ann Surg, 2022, 275(1): 31-36.
20.	Omicron variant: What you need to know. Updated on March 29, 2022. https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html. Accessed on April 19, 2022.

1. 朱家德, 郭惠明. 新冠疫情下的心脏外科: 改变与应对之策. 中国胸心血管外科临床杂志, 2023, 30(2): 162-166.
2. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 2020, 323(11): 1061-1069.
3. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study. Lancet, 2020, 396(10243): 27-38.
4. Guo T, Fan Y, Chen M, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol, 2020, 5(7): 811-818.
5. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 2020, 323(13): 1239-1242.
6. Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol, 2020, 5(7): 802-810.
7. Nguyen TC, Thourani VH, Nissen AP, et al. The effect of COVID-19 on adult cardiac surgery in the United States in 717 103 patients. Ann Thorac Surg, 2022, 113(3): 738-746.
8. El-Boghdadly K, Cook TM, Goodacre T, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia, 2021, 76(7): 940-946.
9. Rohatgi N, Smilowitz NR, Reejhsinghani R. Perioperative cardiovascular considerations prior to elective noncardiac surgery in patients with a history of COVID-19. JAMA Surg, 2022, 157(3): 187-188.
10. Boghdadly KE, Cook TM, Goodacre T, et al. Timing of elective surgery and risk assessment after SARS-CoV-2 infection: An update. Anaesthesia, 2022, 77(5): 580-587.
11. Lieberman N, Racine A, Nair S, et al. Should asymptomatic patients testing positive for SARS-CoV-2 wait for elective surgical procedures? Br J Anaesth, 2022, 128(5): e311-e314.
12. Benedetto U, Goodwin A, Kendall S, et al. A nationwide survey of UK cardiac surgeons' view on clinical decision making during the coronavirus disease 2019 (COVID-19) pandemic. J Thorac Cardiovasc Surg, 2020, 160(4): 968-973.
13. Yang Y, Wang Z, Chen Z, et al. Current status and etiology of valvular heart disease in China: A population-based survey. BMC Cardiovasc Disord, 2021, 21(1): 339.
14. COVIDSurg Collaborative. Outcomes and their state-level variation in patients undergoing surgery with perioperative SARS-CoV-2 infection in the USA: A prospective multicenter study. Ann Surg, 2022, 275(2): 247-251.
15. COVIDSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: An international prospective cohort study. Anaesthesia, 2021, 76(6): 748-758.
16. Deng JZ, Chan JS, Potter AL, et al. The risk of postoperative complications after major elective surgery in active or resolved COVID-19 in the United States. Ann Surg, 2022, 275(2): 242-246.
17. Nahshon C, Bitterman A, Haddad R, et al. Hazardous postoperative outcomes of unexpected COVID-19 infected patients: A call for global consideration of sampling all asymptomatic patients before surgical treatment. World J Surg, 2020, 44(8): 2477-2481.
18. Bryant JM, Boncyk CS, Rengel KF, et al. Association of time to surgery after COVID-19 infection with risk of postoperative cardiovascular morbidity. JAMA Netw Open, 2022, 5(12): e2246922.
19. Prasad NK, Lake R, Englum BR, et al. COVID-19 vaccination associated with reduced postoperative SARS-CoV-2 infection and morbidity. Ann Surg, 2022, 275(1): 31-36.
20. Omicron variant: What you need to know. Updated on March 29, 2022. https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html. Accessed on April 19, 2022.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Perioperative results of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection

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