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].