Change in Surgical Volume and Treatment strategies
The USZ runs a Cardiac Surgery-Program, currently performing about 850 open surgeries and 350 transcatheter interventions yearly. During the peak of the COVID-19-pandemic in Switzerland elective surgery in our institution was banned from March 16 60 April 27 until 27.04.2020. During that time-period, cardiac surgery was performed exclusively on an urgency or emergency basis. A total of 51 major operations, 26 structural interventions and 38 other procedures were performed under the accountability of our clinic during this 6-week period following federal and institutional recommendations. Strikingly the number of structural interventions did not significantly drop when compared to the previous years. Comorbidities and an average age of 77 years all contributed to those patients to be meeting the criteria for an intervention under a non-elective setting (shortening of life expectancy, worsening of the clinical status, permanent damage, hospitalization). With careful selection, patients referred for structural interventions seem to be less susceptible for special regulations on the elective program. Postponement of such interventions is often associated with a shortening of an anyway limited life expectancy and in case of low complication rates, patients treated with modern minimally invasive concepts seldom need critical resources of an ICU [21].