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Timing of urgent cardiac and aortic surgery in Covid-19 positive patients: Earliest safe period for surgery.
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  • Ana Lopez-Marco,
  • Azhar Hussain,
  • Martin Yates,
  • Damian Balmforth,
  • Rakesh Uppal,
  • Aung Oo
Ana Lopez-Marco
Saint Bartholomew's Hospital
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Azhar Hussain
Saint Bartholomew's Hospital
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Martin Yates
Saint Bartholomew's Hospital
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Damian Balmforth
Saint Bartholomew's Hospital
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Rakesh Uppal
Saint Bartholomew's Hospital
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Aung Oo
Saint Bartholomew's Hospital
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Abstract

OBJECTIVES Surgery in COVID-19 patients carries a significant mortality and morbidity but the appropriate waiting period before a surgical intervention after recovering from COVID-19 is not known. We aim to determine the safety of deferring urgent surgery and to identify the earliest safe period for surgery by analysing our experience in patients who underwent cardiac surgery after recovering from COVID-19. METHODS Analysis of all patients undergoing cardiac surgery in our centre during March and April 2020, focusing in those who tested positive for COVID-19 in the pre-operative screening. RESULTS Four patients tested positive for COVID-19 during the preoperative screening. Two of them also showed radiological signs of COVID-19 lung disease. We delayed surgery until they tested negative and the radiological changes improved. None of the patients suffered a deterioration of their cardiac symptoms that mandated expediting the surgeries. As a result of waiting until COVID-19 resolution, all our patients survived the urgent cardiac surgery without developing any COVID-19-related complications. CONCLUSIONS From our experience, defering urgent cardiac surgery in patients with confirmed COVID-19 is safe. Operating as early as 4 days after a negative swab does not increase mortality and morbidity.