1
|
Giamberti A, Lo Rito M, Stellin G, Karl T, Frigiola A. Editorial: Pediatric cardiology and cardiac surgery in developing countries: Current needs and future perspectives. Front Pediatr 2022; 10:1067193. [PMID: 36507130 PMCID: PMC9733665 DOI: 10.3389/fped.2022.1067193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Alessandro Giamberti
- Bambini Cardiopatici nel Mondo Association NGO, Milano, Italy.,Department of Pediatric and Adult Congenital Cardiac Surgery, IRCCS Policlinico San Donato, Milano, Italy
| | - Mauro Lo Rito
- Department of Pediatric and Adult Congenital Cardiac Surgery, IRCCS Policlinico San Donato, Milano, Italy
| | - Giovanni Stellin
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Tom Karl
- Queensland Pediatric Cardiac Service, Queensland Children's Hospital, Brisbane, Australia
| | - Alessandro Frigiola
- Bambini Cardiopatici nel Mondo Association NGO, Milano, Italy.,Department of Pediatric and Adult Congenital Cardiac Surgery, IRCCS Policlinico San Donato, Milano, Italy
| |
Collapse
|
2
|
Chiariello GA, Bruno P, Pavone N, Calabrese M, D'Avino S, Ferraro F, Nesta M, Farina P, Cammertoni F, Pasquini A, Montone RA, Montini L, Massetti M. Bleeding Complications in Patients With Perioperative COVID-19 Infection Undergoing Cardiac Surgery: A Single-Center Matched Case-Control Study. J Cardiothorac Vasc Anesth 2021; 36:1919-1926. [PMID: 34906382 PMCID: PMC8590476 DOI: 10.1053/j.jvca.2021.11.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/02/2021] [Accepted: 11/07/2021] [Indexed: 01/14/2023]
Abstract
Objective Previous studies reported a poor outcome in patients with coronavirus 2019 (COVID-19) undergoing cardiac surgery. Complications most frequently described were respiratory failure, renal failure, and thromboembolic events. In their recent experience, the authors observed a very high incidence of bleeding complications. The purpose of the study was to investigate a possible significant correlation between perioperative COVID-19 infection and hemorrhagic complications compared to non-COVID-19 patients. Design Single-center, observational, retrospective, matched case-control (1:2) study involving patients who underwent open-heart cardiac surgery from February 2020 and March 2021 with positive perioperative diagnosis of COVID-19 infection, matched with patients without COVID-19 infection. Setting Cardiac surgery unit and intensive care unit of a university tertiary center in a metropolitan area. Participants In the study period, 773 patients underwent cardiac surgery on cardiopulmonary bypass (CPB). Among them, 23 consecutive patients had perioperative diagnosis of COVID-19 infection (study group). These patients were compared with 46 corresponding controls (control group) that matched for age, sex, body mass index, and Society of Thoracic Surgeons score. Interventions Open-heart cardiac surgery on CPB. Measurements and Main Results In the study group, 2 patients (9%) died in the intensive care unit from severe respiratory failure, shock, and multiple organ failure. In the study group, patients showed a significantly higher incidence of bleeding complications (48% v 2%, p = 0.0001) and cases of surgical reexploration for bleeding (35% v 2%, p = 0.0001), a higher incidence of severe postoperative thrombocytopenia (39% v 6%, p = 0.0007), and a higher need of blood components transfusions (74% v 30%, p = 0.0006). Chest tubes blood loss and surgical hemostasis time were markedly prolonged (p = 0.02 and p = 0.003, respectively). Conclusions A worrisome increased risk of early and late bleeding complications in COVID-19 patients was observed, and it should be considered when assessing the operative risk. CPB-related inflammatory reaction could exacerbate the deleterious effect of COVID-19 on the coagulation system and likely deviate it toward a hemorrhagic pattern.
Collapse
Affiliation(s)
- Giovanni A Chiariello
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy.
| | - Piergiorgio Bruno
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Natalia Pavone
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Maria Calabrese
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy
| | - Serena D'Avino
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Francesco Ferraro
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Marialisa Nesta
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Piero Farina
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Federico Cammertoni
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Annalisa Pasquini
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Rocco A Montone
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| | - Luca Montini
- Catholic University of The Sacred Heart, Rome, Italy; Department of Intensive Care Medicine and Anesthesiology, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy
| | - Massimo Massetti
- Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy
| |
Collapse
|