Cardiac Surgery during the COVID-19 Pandemic: Perioperative Considerations and Triage Recommendations

The COVID-19 (Coronavirus disease 2019) pandemic caused by SARS-CoV-2 (Sudden Acute Respiratory Syndrome Coronavirus-2) represents the third human affliction attributed to the highly pathogenic coronavirus in the current century. Due to its highly contagious nature and unprecedented global spread, its aggressive clinical presentation and the lack of effective treatment, SARS-CoV-2 infection is causing the losses of thousands of lives and imparting unparalleled strains on healthcare systems around the world. In the current report, we discuss perioperative considerations for patients undergoing cardiac surgery and provide clinicians with recommendations to effectively triage and plan these procedures during the COVID-19 outbreak. This will help reduce the risk of exposure to patients and healthcare workers and allocate resources appropriately to those in greatest need. We include an algorithm for preoperative testing for COVID-19, personal protective equipment (PPE) recommendations, and a classification system to categorize and prioritize common cardiac surgery procedures.