Elective Surgical Procedures

ABC

Research Letter

Impact of the First Wave of the COVID-19 Pandemic on Cardiovascular Surgery in Brazil: Analysis of a Tertiary Reference Center

Luiz Augusto Lisboa et al. Omar Asdrúbal Vilca Mejia Elisandra Trevisan Arita Gustavo Pampolha Guerreiro … Lucas Molinari Veloso da Silveira Carlos Manuel de Almeida Brandão Ricardo Ribeiro Dias Luís Roberto Palma Dallan Leonardo Miana Luiz F. Caneo Marcelo Biscegli Jatene Luís Alberto Oliveira Dallan Fabio Biscegli Jatene

Introduction

The novel viral respiratory infection caused by coronavirus disease 2019 (COVID-19), initially known as 2019-nCoV, emerged in late December 2019 in Wuhan, China and quickly spread throughout Asia, Europe, and USA, characterizing the situation as a pandemic. In May 2020, the World Health Organization declared Brazil a new epicenter of the coronavirus pandemic.

With the alarming levels of spread and severity of COVID-19, major disruptions in routine hospital services have occurred, as hospitals adjust in order to increase the capacity to care for patients with SARS-CoV-2. In this context, elective surgeries were postponed in order to optimize health resources and staffing issues and to protect patients from in-hospital viral transmission.

[…]

Read Full Article

ABC

Original Article

Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery

Jean Allan Costa et al. Maria Lucia Pereira Almeida Tereza Cristina Duque Estrada Guilherme Lobosco Werneck … Alexandre Marins Rocha Maria Luiza Garcia Rosa Mario Luiz Ribeiro Claudio Tinoco Mesquita

Abstract

Background:

The ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries.

Objectives:

To assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk.

Methods:

A total of 211 patients referred for elective surgeries, without suspicion of previous heart diseases, were included in the study. Assessment of patients was conducted by conventional echocardiogram using the ultraportable V Scan (GE) device right after the pre-anesthetic clinical evaluation. We assessed the clinical impact of echocardiography results by using a questionnaire addressed to the anesthetist.

Results:

Mean age of patients was 68.9 ± 7.0 years, 154 were women. The most frequent surgeries were: a) facectomy – cataract – 18; b) inguinal hernia surgery – 18; c) Cholecystectomy – 16. We found 58 normal tests (27.5%), 70 (33.2%) with mild valve reflux, and 83 (39.3%) with relevant abnormality, such as increase in heart chamber size, global and/or segmental contractile dysfunction, significant valve dysfunction or other unspecified. Test results caused delay of surgical procedure for a more detailed cardiac evaluation in 20 (9.5%) patients, and change in anesthetic management in 7 (3.3%).

Conclusion:

There was a considerable clinical impact with the use of the ultraportable echocardiography, since one out of every ten patients evaluated had their clinical management changed due to the detection of previously unsuspected, significant heart diseases, with the potential for severe complications.