Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience
Background The response to COVID-19 has required cancellation of all but the most urgent procedures; there is therefore a need for the reintroduction of a safe elective pathway.Methods This was a study of a pilot pathway performed at Barts Heart Centre for the admission of patients requiring electiv...
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| Format: | Article |
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BMJ Publishing Group
2021-02-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/1/e001446.full |
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| author | Anthony Mathur Andreas Baumbach Andrew Wragg Oliver Guttmann Dan Jones Katrina Comer Jonathan Lambourne Michael Mullen Stephen Hamshere Fizzah Choudhry Krishna Rathod Gordon Mills Gordon Ferguson Majid Akhtar Mick Ozkor Elliot Smith |
| author_facet | Anthony Mathur Andreas Baumbach Andrew Wragg Oliver Guttmann Dan Jones Katrina Comer Jonathan Lambourne Michael Mullen Stephen Hamshere Fizzah Choudhry Krishna Rathod Gordon Mills Gordon Ferguson Majid Akhtar Mick Ozkor Elliot Smith |
| author_sort | Anthony Mathur |
| collection | DOAJ |
| description | Background The response to COVID-19 has required cancellation of all but the most urgent procedures; there is therefore a need for the reintroduction of a safe elective pathway.Methods This was a study of a pilot pathway performed at Barts Heart Centre for the admission of patients requiring elective coronary and structural procedures during the COVID-19 pandemic (April–June 2020). All patients on coronary and structural waiting lists were screened for procedural indications, urgency and adverse features for COVID-19 prognosis and discussed at dedicated multidisciplinary teams. Dedicated admission pathways involving preadmission isolation, additional consent, COVID-19 PCR testing and dedicated clean areas were used.Results 143 patients (101 coronary and 42 structural) underwent procedures (coronary angiography, percutaneous coronary intervention, transcatheter aortic valve intervention and MitralClip) during the study period. The average age was 68.2; 74% were male; and over 93% had one or more moderate COVID-19 risk factors. All patients were COVID-19 PCR negative on admission with (8.1%) COVID-19 antibody positive (swab negative). All procedures were performed successfully with low rates of procedural complications (9.8%). At 2-week follow-up, no patients had symptoms or confirmed COVID-19 infection with significant improvements in quality if life and symptoms.Conclusion We demonstrated that patients undergoing coronary and structural procedures can be safely admitted during the COVID-19 pandemic, with no patients contracting COVID-19 during their admission. Reassuringly, patients reflective of typical practice, that is, those at moderate or higher risk, were treated successfully. This pilot provides important information applicable to other settings, specialties and areas to reintroduce services safely. |
| format | Article |
| id | doaj-art-90c7ead0384f43b5933aac6f59b03085 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-90c7ead0384f43b5933aac6f59b030852024-11-15T14:35:08ZengBMJ Publishing GroupOpen Heart2053-36242021-02-018110.1136/openhrt-2020-001446Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experienceAnthony Mathur0Andreas Baumbach1Andrew Wragg2Oliver Guttmann3Dan Jones4Katrina Comer5Jonathan Lambourne6Michael Mullen7Stephen Hamshere8Fizzah Choudhry9Krishna Rathod10Gordon Mills11Gordon Ferguson12Majid Akhtar13Mick Ozkor14Elliot Smith158 Barts Heart Centre, St Bartholomew`s Hospital, London, UK3 The William Harvey Research Institute, Queen Mary University, London, UKNIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UKCentre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Infectious Diseases, Barts Health NHS Trust, London, UKCardiology, Barts Health NHS Trust, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKCardiology, Barts Health NHS Trust, London, UKBarts Heart Centre, Barts Health NHS Trust, London, UKBackground The response to COVID-19 has required cancellation of all but the most urgent procedures; there is therefore a need for the reintroduction of a safe elective pathway.Methods This was a study of a pilot pathway performed at Barts Heart Centre for the admission of patients requiring elective coronary and structural procedures during the COVID-19 pandemic (April–June 2020). All patients on coronary and structural waiting lists were screened for procedural indications, urgency and adverse features for COVID-19 prognosis and discussed at dedicated multidisciplinary teams. Dedicated admission pathways involving preadmission isolation, additional consent, COVID-19 PCR testing and dedicated clean areas were used.Results 143 patients (101 coronary and 42 structural) underwent procedures (coronary angiography, percutaneous coronary intervention, transcatheter aortic valve intervention and MitralClip) during the study period. The average age was 68.2; 74% were male; and over 93% had one or more moderate COVID-19 risk factors. All patients were COVID-19 PCR negative on admission with (8.1%) COVID-19 antibody positive (swab negative). All procedures were performed successfully with low rates of procedural complications (9.8%). At 2-week follow-up, no patients had symptoms or confirmed COVID-19 infection with significant improvements in quality if life and symptoms.Conclusion We demonstrated that patients undergoing coronary and structural procedures can be safely admitted during the COVID-19 pandemic, with no patients contracting COVID-19 during their admission. Reassuringly, patients reflective of typical practice, that is, those at moderate or higher risk, were treated successfully. This pilot provides important information applicable to other settings, specialties and areas to reintroduce services safely.https://openheart.bmj.com/content/8/1/e001446.full |
| spellingShingle | Anthony Mathur Andreas Baumbach Andrew Wragg Oliver Guttmann Dan Jones Katrina Comer Jonathan Lambourne Michael Mullen Stephen Hamshere Fizzah Choudhry Krishna Rathod Gordon Mills Gordon Ferguson Majid Akhtar Mick Ozkor Elliot Smith Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience Open Heart |
| title | Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience |
| title_full | Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience |
| title_fullStr | Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience |
| title_full_unstemmed | Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience |
| title_short | Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience |
| title_sort | reintroduction of elective cardiac interventions in the era of covid 19 the barts experience |
| url | https://openheart.bmj.com/content/8/1/e001446.full |
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