Klinische und experimentelle Kardiologie
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Adult Cardiac Surgery in the Time of the SARS-CoV-2 Virus: A Report of Eight Cases of Postoperative COVID-19 Infection

Soumer Khedija, Bousnina Mouna, Azabou Nadia, Ben Saida Fatma, Bennour Emna, Louhaichi Sabrine, Jemel Amine

Objective: While COVID-19 respiratory complications can lead to an acute respiratory distress syndrome, the impact of coronavirus disease in patients undergoing cardiac surgery procedures is unknown. The aim of this paper is to describe the baseline characteristics and outcomes of patients who tested positive early after cardiac surgery. We also present measures adopted targeting the new coronavirus pandemic in our department and the way we reorganized to resume the surgical activity in better conditions.

Case presentation: We experienced a crucial SARS-CoV-2 outbreak in our cardiovascular division during the peak of the pandemic in Tunisia with several patients tested positive for the new coronavirus. Here we present eight cases of COVID-19 positive patients on the postoperative course from February 22, 2021 to July 6, 2021. During this period, 148 patients underwent cardiac surgery at the department of Cardio-vascular Surgery of Abderrahmen Mami hospital. Among them, 8 patients were found positive for the SARS-CoV-2 virus after elective operations. The mean age of patients was 55 years (range from 36 to 65 years). Of the 8 patients, 5 were men and 3 were women. Four patients were operated on between February 28, 2021 and March 29, 2021 during the third wave of the pandemic. One had his operation on May 17, 2021 and 3 patients underwent cardiac surgery between June 12, 2021 and June 22, 2021 during the fourth wave of pandemic. The mean time from surgery to COVID-19 diagnosis was 4.62 days. Four patients died on the postoperative course. Twelve health care workers were also affected. Nine of them were moderately symptomatic for cough and mild dyspnea whereas the 3 others were asymptomatic.

Conclusion: The SARS-CoV-2 infection puts health services, including cardiac surgery units, under increasing pressure. Cardiac surgeons are faced with serious challenges induced by this novel virus and ensuing disease that leads to great uncertainty.