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Gerasia R, Mamone G, Amato S, Cucchiara A, Gallo GS, Tafaro C, Fiorello G, Caruso C, Miraglia R. COVID-19 safety measures at the Radiology Unit of a Transplant Institute: the non-COVID-19 patient's confidence with safety procedures. LA RADIOLOGIA MEDICA 2022; 127:426-432. [PMID: 35284986 PMCID: PMC8918076 DOI: 10.1007/s11547-022-01454-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/03/2022] [Indexed: 01/02/2023]
Abstract
PURPOSE To support the wellbeing of both patients and their families, our aim was to investigate the satisfaction of non-COVID in- and out-patients regarding safety measures implemented at our radiology unit of a transplant institute against COVID infection. MATERIALS AND METHODS Over a five-month period, adult patients' feedback was obtained by a questionnaire on the fear of contracting COVID-19 during a radiology examination, the perceived delay in treatment, and the following safety measures implemented: modified schedules to limit the number of patients in the waiting area and to maximize social distancing; assistance by staff when visitors were not admitted; cleaning and disinfection of machines; mask wearing and hand hygiene of staff; and staff advice on hand hygiene and infection control precautions. RESULTS Over a five-month period, our preliminary results (387 patients) showed general patient satisfaction (99.1%) with safety measures applied at our radiology unit. Patients were satisfied with distancing and assistance by staff (100%), cleaning and disinfection (91%), mask wearing and hand hygiene of the staff (97%), and staff advice (94%). There was some criticism of the perceived delay in treatment (7.3%) and in the scheduling of the waiting list (5.4%), with 5.4% fearing contracting the virus. Patients' awareness of safety measures and confidence in the hospital preparedness policy was perceived by all interviewers, and 100% appreciated being questioned. CONCLUSION The feedback given by the non-COVID patient helps to measure the quality in health care, to improve the quality service, and to protect and satisfy more vulnerable patients, also during the COVID-19 pandemic.
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Affiliation(s)
- Roberta Gerasia
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - Giuseppe Mamone
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - Santina Amato
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - Antonino Cucchiara
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - Giuseppe Salvatore Gallo
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - Corrado Tafaro
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - Giuseppe Fiorello
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - Calogero Caruso
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - Roberto Miraglia
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
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2
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Gerasia R, Panarello G, Miraglia R. Embolization of a Renal Solid Bleeding Lesion in Intensive Care Unit in a Critically Ill Patient with Severe Acute Respiratory Syndrome-Related Coronavirus Infection and Difficult Mobilization due to Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy. Cardiovasc Intervent Radiol 2022; 45:892-894. [PMID: 35277727 PMCID: PMC8916067 DOI: 10.1007/s00270-022-03096-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- R. Gerasia
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - G. Panarello
- Department of Anesthesia and Intensive Care, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
| | - R. Miraglia
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy
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Dell'Era G, Colombo C, Forleo GB, Curnis A, Marcantoni L, Racheli M, Sartori P, Notarstefano P, De Salvia A, Guerra F, Ziacchi M, Tondo C, Gandolfi E, De Vecchi F, Mascioli G, Coppolino A, Catuzzo B, Amellone C, Mantica M, D'Ascenzo F, Patti G. Reduction of admissions for urgent and elective pacemaker implant during the COVID-19 outbreak in Northern Italy. J Cardiovasc Med (Hagerstown) 2022; 23:22-27. [PMID: 34545009 DOI: 10.2459/jcm.0000000000001189] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIMS The coronavirus disease-19 (COVID-19) outbreak has been recently associated with lower hospitalization rates for acute coronary syndromes. Aim of the study was to investigate whether a similar behaviour is observed in admissions for urgent pacemaker implant. METHODS This retrospective study included 1315 patients from 18 hospitals in Northern Italy with a high number of COVID-19 cases. Hospitalization rates for urgent pacemaker implant were compared between the following periods: 20 February to 20 April 2020 (case period); from 1 January to 19 February 2020 (intra-year control period); from 20 February to 20 April 2019 (inter-year control period). RESULTS The incidence rate of urgent implants was 5.0/day in the case period, 6.0/day in the intra-year control period and 5.8/day in the inter-year control period. Incidence rate in the case period was significantly lower than both the intra-year [incidence rate ratio (IRR): 0.81, 95% CI 0.67-0.99, P = 0.040] and inter-year control periods (IRR: 0.79, 95% CI 0.66-0.95, P = 0.012); this reduction was highest after the national lockdown (IRR 0.68, 95% CI 0.52-0.91, P = 0.009). The prevalence of residents in rural areas undergoing urgent pacemaker implant was lower in the case period (36%) than in both the intra-year (47%, P = 0.03) and inter-year control periods (51%, P = 0.002). Elective pacemaker implants also decreased in the case period, with the incidence rate here being 3.5/day vs. 6.4/day in the intra-year (-45%) and 6.9/day in the inter-year period (-49%). CONCLUSION Despite severe clinical patterns, the COVID-19 outbreak has negatively affected the population presentation to Emergency Departments for bradyarrhythmias requiring urgent pacemaker implant in Northern Italy. This mainly occurred after the national lockdown and concerned patients living in rural areas.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital 'Umberto I - Lancisi - Salesi', Ancona
| | - Matteo Ziacchi
- Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, S. Orsola-Malpighi University Hospital, Bologna
| | - Claudio Tondo
- Heart Rhythm Center, Centro Cardiologico Monzino, IRCCS, Department of Clinical Sciences and Community Health, University of Milan, Milan
| | | | | | - Giosué Mascioli
- Division of Electrophysiology - Humanitas Gavazzeni - Bergamo
| | - Aldo Coppolino
- ASL CN1 SC di Cardiologia, Ospedale SS. Annunziata, Savigliano (Cuneo)
| | | | | | | | | | - Giuseppe Patti
- Ospedale Maggiore della Carità Hospital, Novara
- University of Eastern Piedmont, Novara, Italy
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4
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Diemberger I, Vicentini A, Cattafi G, Ziacchi M, Iacopino S, Morani G, Pisanò E, Molon G, Giovannini T, Russo AD, Boriani G, Bertaglia E, Biffi M, Bongiorni MG, Rordorf R, Zucchelli G. The Impact of COVID-19 Pandemic and Lockdown Restrictions on Cardiac Implantable Device Recipients with Remote Monitoring. J Clin Med 2021; 10:jcm10235626. [PMID: 34884329 PMCID: PMC8658316 DOI: 10.3390/jcm10235626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/13/2021] [Accepted: 11/18/2021] [Indexed: 12/22/2022] Open
Abstract
From 2020, many countries have adopted several restrictions to limit the COVID-19 pandemic. The forced containment impacted on healthcare organizations and the everyday life of patients with heart disease. We prospectively analyzed data recorded from implantable defibrillators and/or cardiac resynchronization devices of Italian patients during the lockdown (LDP), post-lockdown period (PLDP) and a control period (CP) of the previous year. We analyzed device data of the period 9 March 2019–31 May 2020 of remotely monitored patients from 34 Italian centers. Patients were also categorized according to areas with high/low infection prevalence. Among 696 patients, we observed a significant drop in median activity in LDP as compared to CP that significantly increased in the PLDP, but well below CP (all p < 0.0001). The median day heart rate and heart rate variability showed a similar trend. This behavior was associated during LDP with a significant increase in the burden of atrial arrhythmias (p = 0.0150 versus CP) and of ventricular arrhythmias [6.6 vs. 1.5 per 100 patient-weeks in CP; p = 0.0026]; the latter decreased in PLDP [0.3 per 100 patient-weeks; p = 0.0035 vs. LDP]. No modifications were recorded in thoracic fluid levels. The high/low prevalence of COVID-19 infection had no significant impact. We found an increase in the arrhythmic burden in LDP coupled with a decrease in physical activity and heart rate variability, without significant modifications of transthoracic impedance, independent from COVID-19 infection prevalence. These findings suggest a negative impact of the COVID-19 pandemic, probably related to lockdown restrictions.
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Affiliation(s)
- Igor Diemberger
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy
- UOC di Cardiologia, IRCCS Policlinico S.Orsola-Malpighi, 40138 Bologna, Italy; (M.Z.); (M.B.)
- Correspondence: ; Tel.: +39-051-214-9034
| | - Alessandro Vicentini
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (A.V.); (R.R.)
| | - Giuseppe Cattafi
- Cardiologia 3, Dipartimento Cardiotoracovascolare, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy;
| | - Matteo Ziacchi
- UOC di Cardiologia, IRCCS Policlinico S.Orsola-Malpighi, 40138 Bologna, Italy; (M.Z.); (M.B.)
| | | | - Giovanni Morani
- UOC di Cardiologia, Azienda Ospedaliero Universitaria Integrata di Verona, 37126 Verona, Italy;
| | - Ennio Pisanò
- UOC di Cardiologia, Ospedale Vito Fazzi Lecce, 73100 Lecce, Italy;
| | - Giulio Molon
- UOC di Cardiologia, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar, Italy;
| | | | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti”, 60126 Ancona, Italy;
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, Italy;
| | - Emanuele Bertaglia
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, Azienda Ospedaliera Universitaria di Padova, 35128 Padova, Italy;
| | - Mauro Biffi
- UOC di Cardiologia, IRCCS Policlinico S.Orsola-Malpighi, 40138 Bologna, Italy; (M.Z.); (M.B.)
| | - Maria Grazia Bongiorni
- Second Division of Cardiology, Cardio Thoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (M.G.B.); (G.Z.)
| | - Roberto Rordorf
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (A.V.); (R.R.)
| | - Giulio Zucchelli
- Second Division of Cardiology, Cardio Thoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (M.G.B.); (G.Z.)
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Pellegrini D, Fiocca L, Pescetelli I, Canova P, Vassileva A, Faggi L, Senni M, Guagliumi G. Effect of Respiratory Impairment on the Outcomes of Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction and Coronavirus Disease-2019 (COVID-19). Circ J 2021; 85:1701-1707. [PMID: 33658444 DOI: 10.1253/circj.cj-20-1166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Coronavirus Disease-2019 (COVID-19) may impair outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The extent of this phenomenon and its mechanisms are unclear.Methods and Results:This study prospectively included 50 consecutive STEMI patients admitted to our center for primary percutaneous coronary intervention (PCI) at the peak of the Italian COVID-19 outbreak. At admission, a COVID-19 test was positive in 24 patients (48%), negative in 26 (52%). The primary endpoint was in-hospital all-cause mortality. Upon admission, COVID-19 subjects had lower PO2/FiO2 (169 [100-425] vs. 390 [302-477], P<0.01), more need for oxygen support (62.5% vs. 26.9%, P=0.02) and a higher rate of myocardial dysfunction (ejection fraction <30% in 45.8% vs. 19.2%, P=0.04). All patients underwent emergency angiography. In 12.5% of COVID-19 patients, no culprit lesions were detected, thus PCI was performed in 87.5% and 100% of COVID-19 positive and negative patients, respectively (P=0.10). Despite a higher rate of obstinate thrombosis in the COVID-19 group (47.6% vs. 11.5%, P<0.01), the PCI result was similar (TIMI 2-3 in 90.5% vs. 100%, P=0.19). In-hospital mortality was 41.7% and 3.8% in COVID-19 positive and negative patients, respectively (P<0.01). Respiratory failure was the leading cause of death (80%) in the COVID-19 group, frequently associated with severe myocardial dysfunction. CONCLUSIONS In-hospital mortality of COVID-19 patients with STEMI remains high despite successful PCI, mainly due to coexisting severe respiratory failure. This may be a critical factor in patient management and treatment selection.
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Affiliation(s)
| | - Luigi Fiocca
- Cardiovascular Department, Papa Giovanni XXIII Hospital
| | | | - Paolo Canova
- Cardiovascular Department, Papa Giovanni XXIII Hospital
| | | | - Lara Faggi
- Cardiovascular Department, Papa Giovanni XXIII Hospital
| | - Michele Senni
- Cardiovascular Department, Papa Giovanni XXIII Hospital
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6
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Giacomin E, Barioli A, Favero L, Lanzellotti D, Calzolari D, Daniotti A, Cernetti C. Safety and Feasibility of Transcatheter Aortic Valve Replacement in COVID-19 Patients: A Case Series. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2021; 28S:68-71. [PMID: 33840619 PMCID: PMC8023787 DOI: 10.1016/j.carrev.2021.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/15/2021] [Accepted: 03/30/2021] [Indexed: 11/27/2022]
Abstract
In 2020, the coronavirus disease 2019 (COVID-19) pandemic has led to a decrease in interventional treatment for structural heart disease worldwide. In this context, the management of patients with symptomatic severe aortic stenosis (AS) or bioprosthetic valve dysfunction (BVD) represents a clinical challenge, as a delay in aortic valve replacement procedures may increase short-term morbidity and mortality. We report four cases of TAVR performed in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. All of them were discharged in good clinical conditions and no adverse events were reported at 30 days follow-up. Our experience suggests that in selected patients with mild SARS-CoV-2 infection and symptomatic native AS or BVD, TAVR has a favorable short-term outcome.
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Affiliation(s)
- Enrico Giacomin
- Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy; Department of Cardiac, Vascular, Thoracic Sciences and Public Health, University of Padua, Italy.
| | - Alberto Barioli
- Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy
| | - Luca Favero
- Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy
| | - Davide Lanzellotti
- Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy
| | - Diego Calzolari
- Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy
| | - Alessandro Daniotti
- Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy
| | - Carlo Cernetti
- Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy
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7
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Borghesi M, Zilio F, Braito G, Dallago M, Muraglia S, Todaro D, Bonmassari R. How to keep the cath-lab of a hub center "covid free" during the pandemic in a hub & spoke cardiology network: a single center experience and literature review. Minerva Cardiol Angiol 2021; 70:468-475. [PMID: 33703854 DOI: 10.23736/s2724-5683.20.05477-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND north of Italy has been one of the most affected area in the world by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). The healthcare system has been overwhelmed by the huge number of patients in need of mechanical ventilation or intensive care, resulting in a delay of treatment of patients with acute coronary syndrome (ACS), due to a crash in STEMI networks and closure of a certain number of hub centers, and to a delay in patients' seeking for medical evaluation for chest pain or angina-equivalent symptoms. METHODS in the Trentino region, a mountainous area with about 500,000 inhabitants, very close to Lombardy that was the epicenter of the pandemic in Italy, to avoid these dramatic consequences, we developed a new protocol tailored to our specificity to keep our institution, and above all the cath-lab, clean from the SARS-CoV-2 infection, to ensure full operativity for cardiologic emergencies. RESULTS Applying this protocol during the two months of the peak of the infection in Italy no one of the staff members of the cath-lab, the ICCU or the cardiology ward tested positive to nasal swab for SARS-CoV-2 and the same result was obtained for all the patients admitted to our units. CONCLUSIONS our real world experience shows that during the COVID-19 pandemic, quick activation of an appropriate protocol defining specific pathways for patients with a medical urgency is effective in minimizing healthcare personnel exposure and to preserve full operativity of the hub centers. This issue will be of a crucial importance, now that we are facing the second wave of the pandemic.
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Affiliation(s)
- Marco Borghesi
- Interventional Cardiology, Department of Cardiology, Santa Chiara Hospital, Trento, Italy -
| | - Filippo Zilio
- Interventional Cardiology, Department of Cardiology, Santa Chiara Hospital, Trento, Italy
| | - Giuseppe Braito
- Interventional Cardiology, Department of Cardiology, Santa Chiara Hospital, Trento, Italy
| | - Michele Dallago
- Interventional Cardiology, Department of Cardiology, Santa Chiara Hospital, Trento, Italy
| | - Simone Muraglia
- Interventional Cardiology, Department of Cardiology, Santa Chiara Hospital, Trento, Italy
| | - Daniel Todaro
- Interventional Cardiology, Department of Cardiology, Santa Chiara Hospital, Trento, Italy
| | - Roberto Bonmassari
- Interventional Cardiology, Department of Cardiology, Santa Chiara Hospital, Trento, Italy
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8
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Piccolo R, Esposito G. Percutaneous coronary intervention in patients with COVID-19 and acute coronary syndrome: What if the old normal became the new normal? Catheter Cardiovasc Interv 2021; 97:199-200. [PMID: 33587807 PMCID: PMC8014784 DOI: 10.1002/ccd.29480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 01/10/2021] [Indexed: 11/09/2022]
Abstract
The management of COVID‐19 patients with acute coronary syndrome (ACS) remains challenging. This initial experience supports the safety and efficacy of invasive assessment in patients with COVID‐19 and ACS as well as the safety of the procedure for healthcare personnel. The study findings raise the question of whether we should continue to follow “COVID‐19 guidelines” suggesting a more conservative approach to ACS patients with COVID‐19 or rather go back to a more unrestricted use of invasive angiography and revascularization.
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Affiliation(s)
- Raffaele Piccolo
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giovanni Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.,UNESCO Chair on Health Education and Sustainable Development, University of Naples Federico II, Naples, Italy
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9
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Tomasoni D, Adamo M, Italia L, Branca L, Chizzola G, Fiorina C, Lupi L, Inciardi RM, Cani DS, Lombardi CM, Curello S, Metra M. Impact of COVID-2019 outbreak on prevalence, clinical presentation and outcomes of ST-elevation myocardial infarction. J Cardiovasc Med (Hagerstown) 2020; 21:874-881. [PMID: 32941325 DOI: 10.2459/jcm.0000000000001098] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIMS The aim of this study was to report the prevalence, clinical features and outcomes of patients with ST-elevation myocardial infarction (STEMI) hospitalized during the Corona-Virus Disease 2019 (COVID-19) outbreak compared with those admitted in a previous equivalent period. METHODS AND RESULTS Eighty-five patients admitted for STEMI at a high-volume Italian centre were included. Patients hospitalized during the COVID-19 outbreak (21 February-10 April 2020) (40%) were compared with those admitted in pre-COVID-19 period (3 January-20 February 2020) (60%). A 43% reduction in STEMI admissions was observed during the COVID-19 outbreak compared with the previous period. Time from symptom onset to first medical contact (FMC) and time from FMC to primary percutaneous coronary intervention (PPCI) were longer in patients admitted during the COVID-19 period compared with before [148 (79-781) versus 130 (30-185) min; P = 0.018, and 75 (59-148)] versus 45 (30-70) min; P < 0.001]. High-sensitive troponin T levels on admission were also higher. In-hospital mortality was 12% in the COVID-19 phase versus 6% in the pre-COVID-19 period. Incidence of the composite end-point, including free-wall rupture, severe left ventricular dysfunction, left ventricular aneurysm, severe mitral regurgitation and pericardial effusion, was higher during the COVID-19 than the pre-COVID-19 period (19.6 versus 41.2%; P = 0.030; odds ratio = 2.87; 95% confidence interval 1.09-7.58). CONCLUSION The COVID-19 pandemic had a significant impact on the STEMI care system reducing hospital admissions and prolonging revascularization time. This translated into a worse patient prognosis due to more STEMI complications.
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Affiliation(s)
- Daniela Tomasoni
- Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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10
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Attisano T, Silverio A, Bellino M, Tumscitz C, Tarantino FF, Santarelli A, Baldi C, Citro R, Galasso G. Balloon aortic valvuloplasty for urgent treatment of severe aortic stenosis during coronavirus disease 2019 pandemic: a case report. ESC Heart Fail 2020; 7:4348-4352. [PMID: 32949219 PMCID: PMC7537034 DOI: 10.1002/ehf2.13003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 12/31/2022] Open
Abstract
An 86‐year‐old man affected by severe aortic stenosis (AS) was referred to our institution owing to decompensated heart failure. Three months before, the patient was scheduled for transcatheter aortic valve implantation (TAVI), which was postponed owing to the coronavirus disease 2019 (COVID‐19) outbreak. Owing to COVID‐19 suspicion, he underwent nasopharyngeal swab and was temporarily isolated. However, the rapid deterioration of clinical and haemodynamic conditions prompted us to perform balloon aortic valvuloplasty (BAV) as bridge to TAVI. The patient's haemodynamics improved; and the next day, the reverse transcriptase–polymerase chain reaction for COVID‐19 was negative. At Day 5, he underwent TAVI procedure. Subsequent clinical course was uneventful. During COVID‐19 pandemic, the deferral of TAVI procedure should be assessed on a case‐by‐case basis to avoid delay in patients at high risk for adverse events. BAV may be an option when TAVI is temporarily contraindicated such as in AS patients suspected for COVID‐19.
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Affiliation(s)
- Tiziana Attisano
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Angelo Silverio
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Michele Bellino
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Carlo Tumscitz
- Department of Cardiology, University Hospital of Ferrara, Ferrara, Italy
| | | | - Andrea Santarelli
- Interventional Cath Lab Unit, Cardiovascular Department, Infermi Hospital, Rimini, Italy
| | - Cesare Baldi
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Rodolfo Citro
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Gennaro Galasso
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
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Pilato E, Pinna GB, Parisi V, Manzo R, Comentale G. Mechanical complications of myocardial infarction during COVID-19 pandemic: An Italian single-centre experience. Heart Lung 2020; 49:779-782. [PMID: 32980627 PMCID: PMC7500899 DOI: 10.1016/j.hrtlng.2020.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 12/03/2022]
Abstract
COVID-19 pandemic triggered in many patients the fear to go to the emergency rooms in order to avoid a possible infection. This phenomenon caused a significant reduction in acute coronary syndrome-related interventional procedures with a subsequent increase in critical hospitalizations and post-infarction mechanical complications. A case series of cardiac ruptures during the COVID-19 lockdown and the surgical treatment of a huge post-ischemic cardiac pseudoaneurysm complicated by a “contained” free wall rupture are presented.
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Affiliation(s)
- Emanuele Pilato
- Cardiac Surgery, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Italy
| | - Giovanni Battista Pinna
- Cardiac Surgery, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Italy
| | - Valentina Parisi
- Department of Medical Translational Sciences, University of Napoli "Federico II", Italy
| | - Rachele Manzo
- Cardiac Surgery, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Italy
| | - Giuseppe Comentale
- Cardiac Surgery, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Italy.
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12
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Kulkarni P, Mahadevappa M, Alluri S. COVID-19 Pandemic and the Impact on the Cardiovascular Disease Patient Care. Curr Cardiol Rev 2020; 16:173-177. [PMID: 32564757 PMCID: PMC7536811 DOI: 10.2174/1573403x16666200621154842] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/30/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic has emerged as a serious global threat causing a large number of fatalities and putting enormous strain on the health care resources across the world. This has resulted in preferentially triaging the coronavirus infected patients and placing others, especially cardiovascular patients at increased risk for adverse complications. The effective management of cardiac patients in the hospital environment during this COVID-19 pandemic has emerged as a real challenge. We try to address this issue and also highlight the interplay between COVID-19 and cardiovascular diseases. We hereby review the available literature and emerging guidelines about cardiovascular implications related to COVID-19 which will have a bearing on the patient care, health care professionals and cardiac centres.
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Affiliation(s)
- Prashanth Kulkarni
- Department of Cardiology, Care Hospitals, Hi-Tech City, Hyderabad, India
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13
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Naqvi SHR, Fatima M, Gerges F, Moscatelli S, Oz TK, Kotlar I, Babazade N, Hashemi A, Almaghraby AM. Coronavirus Disease 2019 and Catheterisation Laboratory Considerations: "Looking for Essentials". Eur Cardiol 2020; 15:e57. [PMID: 32905111 PMCID: PMC7463326 DOI: 10.15420/ecr.2020.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/24/2020] [Indexed: 01/25/2023] Open
Abstract
The current coronavirus disease 2019 (COVID-19) outbreak is a significant health crisis that impacts every healthcare system worldwide, and has led to a dramatic change in dealing with different diseases during the pandemic. Interventional cardiologists are frontline workers who deal with many cardiovascular emergencies, either in patients with proven COVID-19 or in suspected cases. Many heart associations worldwide are currently setting appropriate recommendations for the management of emergency cardiac interventions. In this expert opinion, the authors highlight the essential requirements in the cardiac catheterisation laboratory during the COVID-19 pandemic.
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Affiliation(s)
| | - Madiha Fatima
- Cardiology Department, National Institute of Cardiovascular Diseases Sindh, Pakistan
| | - Fady Gerges
- Cardiovascular Sciences Department, NMC Speciality Hospital Al Ain, United Arab Emirates
| | - Sara Moscatelli
- Clinic of Cardiovascular Diseases, University of Genoa Genoa, Italy
| | | | - Irina Kotlar
- Cardiology Department, University Clinic of Cardiology Skopje, North Macedonia
| | - Nigar Babazade
- Cardiology Department, Baku Health Clinic Baku, Azerbaijan
| | - Arash Hashemi
- Cardiology Department, Erfan General Hospital Tehran, Iran
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14
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Ing RJ, Barrett C, Chatterjee D, Twite M, Whitney GM. Perioperative Preparations for COVID-19: The Pediatric Cardiac Team Perspective. J Cardiothorac Vasc Anesth 2020; 34:2307-2311. [PMID: 32451272 PMCID: PMC7187810 DOI: 10.1053/j.jvca.2020.04.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/14/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Richard J Ing
- Department of Anesthesiology; University of Colorado School of Medicine
| | - Cindy Barrett
- University of Colorado School of Medicine; Department of Cardiology, Children's Hospital Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Mark Twite
- Department of Anesthesiology; University of Colorado School of Medicine
| | - Gina M Whitney
- Department of Anesthesiology; University of Colorado School of Medicine
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15
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Quadri G, Rognoni A, Cerrato E, Baralis G, Boccuzzi G, Brscic E, Conrotto F, De Benedictis M, De Martino L, Di Leo A, Ferrari F, Gagnor A, Greco Lucchina GP, Montaldo T, Patti G, Gribaudo E, Reale MA, Soldà P, Tomassini F, Truffa A, Ugo F, Varbella F, Esposito G, Tarantini G, Musumeci G. Catheterization laboratory activity before and during COVID-19 spread: A comparative analysis in Piedmont, Italy, by the Italian Society of Interventional Cardiology (GISE). Int J Cardiol 2020; 323:288-291. [PMID: 32858138 PMCID: PMC7446645 DOI: 10.1016/j.ijcard.2020.08.072] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/14/2020] [Accepted: 08/21/2020] [Indexed: 01/08/2023]
Abstract
Background COronaVIrus Disease 19 (COVID-19) led to the reorganization of Cardiology Units in terms of working spaces and healthcare personnel. In this scenario, both outpatient visits and elective interventional cardiology procedures were suspended and/or postponed. We aimed to report the impact of COVID-19 on interventional coronary and structural procedures in Piedmont, Italy. Methods The number of coronary angiographies (CAG), percutaneous coronary interventions (PCI), primary PCI (pPCI), transcatheter aortic valve replacements (TAVR) and Mitraclip performed in Piedmont between March 1st and April 20th, 2020 (CoV-time) were collected from each catheterization laboratory and compared to the number of procedures performed the year before in the same months (NoCoV-time). Results Procedural data from 18 catheterization laboratories were collected. Both coronary (5498 versus 2888: difference: −47.5%; mean 305.4 VS 160.4; p = 0.002) and structural (84 versus 17: difference: −79.8%; mean 4.7 Vs 0.9; p < 0.001) procedures decreased during CoV-time compared to NoCoV-time. In particular, coronary angiographies (1782 versus 3460), PCI (1074 versus 1983), p PCI (271 versus 410), TAVR (11 versus 72) and Mitraclip (6 versus 12) showed a reduction of 48.5%, 45.7%, 33.7%, 84.7% and 50.0%, respectively (all p for comparison <0.05). Conclusions Compared to the same time-period in 2019, both coronary and structural interventional procedures during COVID-19 epidemic suffered a dramatic decrease in Piedmont, Italy. Organizational change and structured clinical pathways should be created, together with awareness campaigns. COronaVIrus Disease 19 (COVID-19) led to the reorganization of Cardiology Units Interventional procedures during COVID-19 suffered a dramatic decrease in Piedmont Structured clinical pathways should be created, together with awareness campaigns.
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Affiliation(s)
- Giorgio Quadri
- Interventional Cardiology Unit, Ospedale degli Infermi, Rivoli and AOU San Luigi Gonzaga, Orbassano, Turin, Italy.
| | - Andrea Rognoni
- Cardiology Department, AOU Maggiore della Carità, Novara, Italy
| | - Enrico Cerrato
- Interventional Cardiology Unit, Ospedale degli Infermi, Rivoli and AOU San Luigi Gonzaga, Orbassano, Turin, Italy
| | - Giorgio Baralis
- Division of Cardiology, Ospedale Santa Croce e Carle, Cuneo, Italy
| | - Giacomo Boccuzzi
- Interventional Cardiology Unit, Ospedale San Giovanni Bosco, Turin, Italy
| | - Elvis Brscic
- Division of Cardiology, Maria Pia Hospital, Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Città della Salute e della Scienza, Turin, Italy
| | | | - Leonardo De Martino
- Interventional Cardiology Unit, Ospedale S. Biagio, Domodossola, Verbania, Italy
| | - Angelo Di Leo
- Interventional Cardiology Unit, Ciriè, Ivrea and Chivasso Hospitals, Turin, Italy
| | - Fabio Ferrari
- Interventional Cardiology Unit, Ospedale degli Infermi, Rivoli and AOU San Luigi Gonzaga, Orbassano, Turin, Italy
| | - Andrea Gagnor
- Division of Cardiology, Ospedale Maria Vittoria, Turin, Italy
| | | | - Tiziana Montaldo
- Division of Cardiology, Ospedale San Lazzaro, Alba, Cuneo, Italy
| | - Giuseppe Patti
- Cardiology Department, AOU Maggiore della Carità, Novara, Italy; University of Eastern Piedmont, Novara, Italy
| | - Elena Gribaudo
- Division of Cardiology, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy
| | | | - Pierluigi Soldà
- Division of Cardiology, Ospedale degli Infermi, Biella, Italy
| | - Francesco Tomassini
- Interventional Cardiology Unit, Ospedale degli Infermi, Rivoli and AOU San Luigi Gonzaga, Orbassano, Turin, Italy
| | | | - Fabrizio Ugo
- Division of Cardiology, Ospedale Sant'Andrea, Vercelli, Italy
| | - Ferdinando Varbella
- Interventional Cardiology Unit, Ospedale degli Infermi, Rivoli and AOU San Luigi Gonzaga, Orbassano, Turin, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, Università Federico II, Naples, Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, Padova, Italy
| | - Giuseppe Musumeci
- Division of Cardiology, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy
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16
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Zhang Y, Coats AJ, Zheng Z, Adamo M, Ambrosio G, Anker SD, Butler J, Xu D, Mao J, Khan MS, Bai L, Mebazaa A, Ponikowski P, Tang Q, Ruschitzka F, Seferovic P, Tschöpe C, Zhang S, Gao C, Zhou S, Senni M, Zhang J, Metra M. Management of heart failure patients withCOVID‐19: a joint position paper of the Chinese Heart Failure Association & National Heart Failure Committee and the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2020; 22:941-956. [PMID: 32463543 DOI: 10.1002/ejhf.1915] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Yuhui Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences & Peking Union Medical College Beijing China
| | | | - Zhe Zheng
- Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences & Peking Union Medical College Beijing China
| | - Marianna Adamo
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public HealthUniversity of Brescia Brescia Italy
| | - Giuseppe Ambrosio
- Division of CardiologyUniversity of Perugia School of Medicine Perugia Italy
| | - Stefan D. Anker
- Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site BerlinCharité Universitätsmedizin Berlin Berlin Germany
| | - Javed Butler
- Department of MedicineUniversity of Mississippi Medical Center Jackson MS USA
| | - Dingli Xu
- Key Laboratory for Organ Failure Research, Department of CardiologyNanfang Hospital, Southern Medical University, Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangzhou China
| | - Jingyuan Mao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine Tianjin China
| | | | - Ling Bai
- Department of Cardiovascular MedicineThe First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Alexandre Mebazaa
- Université de Paris, Paris, France; U942 Inserm – MASCOT and Department of Anaesthesia and Critical CareUniversity Hospitals Saint Louis‐Lariboisière, APHP Paris France
| | - Piotr Ponikowski
- Center for Heart DiseasesUniversity Hospital, Medical University Wroclaw Poland
| | - Qizhu Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research InstituteWuhan University, Hubei Key Laboratory of Cardiology Wuhan China
| | - Frank Ruschitzka
- University Heart CentreUniversity Hospital Zurich Zurich Switzerland
| | - Petar Seferovic
- Clinic of Endocrinology, Diabetes and Metabolic DiseasesBelgrade University Medical Center Belgrade Serbia
| | - Carsten Tschöpe
- Department of Cardiology, Campus Virchow KlinikumCharite ‐ Universitaetsmedizin Berlin Berlin Germany
| | - Shuyang Zhang
- Department of Cardiology, Peking Union Medical College & Chinese Academy of Medical SciencePeking Union Medical College Hospital Beijing China
| | - Chuanyu Gao
- Department of Cardiology, Henan Provincial People's HospitalFuwai Central China Cardiovascular Hospital Zhengzhou China
| | - Shenghua Zhou
- Department of CardiologyThe Second Xiangya Hospital of Central South University Changsha China
| | - Michele Senni
- Cardiology Division, Cardiovascular DepartmentPapa Giovanni XXIII Hospital Bergamo Italy
| | - Jian Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences & Peking Union Medical College Beijing China
| | - Marco Metra
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public HealthUniversity of Brescia Brescia Italy
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17
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Costa IBSDS, Rochitte CE, Campos CM, Barberato SH, de Oliveira GMM, Lopes MACQ, Nomura CH, Abizaid AA, Cerri G, Kalil R, Hajjar LA. Cardiovascular Imaging and Interventional Procedures in Patients with Novel Coronavirus Infection. Arq Bras Cardiol 2020; 115:111-126. [PMID: 32813825 PMCID: PMC8384321 DOI: 10.36660/abc.20200370] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 12/17/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.
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Affiliation(s)
- Isabela Bispo Santos da Silva Costa
- Universidade de São PauloInstituto do Câncer do Estado de São PauloSão PauloSPBrasil Universidade de São Paulo Instituto do Câncer do Estado de São Paulo , São Paulo , SP - Brasil
| | - Carlos Eduardo Rochitte
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasil Universidade de São Paulo Instituto do Coração , São Paulo , SP - Brasil
- Hospital do CoraçãoSão PauloSPBrasil Hospital do Coração , São Paulo , SP - Brasil
- Hospital Pró-CardíacoRio de JaneiroRJBrasil Hospital Pró-Cardíaco , Rio de Janeiro , RJ - Brasil
| | - Carlos M. Campos
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasil Universidade de São Paulo Instituto do Coração - Hemodinâmica e Cardiologia Intervencionista, São Paulo , SP - Brasil
- Hospital Israelita Albert EinsteinSão PauloSPBrasil Hospital Israelita Albert Einstein - Hemodinâmica e Cardiologia Intervencionista, São Paulo , SP - Brasil
| | - Silvio Henrique Barberato
- CardioEcoCuritibaPRBrasil CardioEco -Centro de Diagnóstico Cardiovascular, Curitiba , PR - Brasil
- Quanta DiagnósticoCuritibaPRBrasil Quanta Diagnóstico – Ecocardiografia, Curitiba , PR - Brasil
| | - Gláucia Maria Moraes de Oliveira
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro – Cardiologia, Rio de Janeiro , RJ - Brasil
| | - Marcelo Antônio Cartaxo Queiroga Lopes
- Hospital Alberto Urquiza WanderleyJoão PessoaPBBrasil Hospital Alberto Urquiza Wanderley - Hemodinâmica e Cardiologia Intervencionista, João Pessoa , PB - Brasil
- Hospital Metropolitano Dom José Maria PiresJoão PessoaPBBrasil Hospital Metropolitano Dom José Maria Pires , João Pessoa , PB - Brasil
- Sociedade Brasileira de CardiologiaRio de JaneiroRJBrasil Sociedade Brasileira de Cardiologia , Rio de Janeiro , RJ - Brasil
| | - Cesar Higa Nomura
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasil Universidade de São Paulo Instituto do Coração , São Paulo , SP - Brasil
| | - Alexandre A. Abizaid
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasil Universidade de São Paulo Instituto do Coração , São Paulo , SP - Brasil
- Hospital Sírio LibanêsSão PauloSPBrasil Hospital Sírio Libanês , São Paulo , SP - Brasil
| | - Giovanni Cerri
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasil Universidade de São Paulo Instituto do Coração , São Paulo , SP - Brasil
| | - Roberto Kalil
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasil Universidade de São Paulo Instituto do Coração , São Paulo , SP - Brasil
| | - Ludhmila Abrahão Hajjar
- Universidade de São PauloInstituto do Câncer do Estado de São PauloSão PauloSPBrasil Universidade de São Paulo Instituto do Câncer do Estado de São Paulo , São Paulo , SP - Brasil
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasil Universidade de São Paulo Instituto do Coração , São Paulo , SP - Brasil
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18
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Chieffo A, Stefanini GG, Price S, Barbato E, Tarantini G, Karam N, Moreno R, Buchanan GL, Gilard M, Halvorsen S, Huber K, James S, Neumann FJ, Möllmann H, Roffi M, Tavazzi G, Ferré JM, Windecker S, Dudek D, Baumbach A. EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic. EUROINTERVENTION 2020; 16:233-246. [PMID: 32404302 DOI: 10.4244/eijy20m05_01] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures.
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Affiliation(s)
- Alaide Chieffo
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
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19
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Pignatti M, Pinto V, Miralles MEL, Giorgini FA, Cannamela G, Cipriani R. How the COVID-19 pandemic changed the Plastic Surgery activity in a regional referral center in Northern Italy. J Plast Reconstr Aesthet Surg 2020; 73:1348-1356. [PMID: 32499187 PMCID: PMC7255253 DOI: 10.1016/j.bjps.2020.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/09/2020] [Indexed: 11/17/2022]
Abstract
The Covid 19 epidemic has modified the way that plastic surgeons can treat their patients. At our hospital all elective surgery was canceled and only the more severe cases were admitted. The outpatient department activity has been reduced also. We present the number and diagnoses of patients, treated as in- and out-patients, during seven weeks from the onset of the epidemic, comparing our activity from the lockdown of elective surgery with the numbers and diagnoses observed during the same weeks of last year. Finally we underline the importance of using telemedicine and web-based tools to transmit images of lesions that need the surgeon's evaluation, and can be used by the patient to keep in touch with a doctor during the distressing time of delay of the expected procedure.
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Affiliation(s)
- Marco Pignatti
- Plastic Surgery, Policlinico di Sant'Orsola - DIMES, University of Bologna, Via Massarenti, 9, 40138 Bologna, Italy.
| | | | - Maria Elisa Lozano Miralles
- Plastic Surgery, Policlinico di Sant'Orsola, Bologna, Italy; Plastic Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Italy
| | - Federico A Giorgini
- Plastic Surgery, Policlinico di Sant'Orsola, Bologna, Italy; Plastic Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Italy
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20
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Lauck S, Forman J, Borregaard B, Sathananthan J, Achtem L, McCalmont G, Muir D, Hawkey MC, Smith A, Højberg Kirk B, Wood DA, Webb JG. Facilitating transcatheter aortic valve implantation in the era of COVID-19: Recommendations for programmes. Eur J Cardiovasc Nurs 2020; 19:537-544. [PMID: 32498556 PMCID: PMC7717283 DOI: 10.1177/1474515120934057] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The COVID-19 pandemic continues to significantly impact the treatment of people living with aortic stenosis, and access to transcatheter aortic valve implantation. Transcatheter aortic valve implantation (TAVI) programmes require unique coordinated processes that are currently experiencing multiple disruptions and are guided by rapidly evolving protocols. We present a series of recommendations for TAVI programmes to adapt to the new demands, based on recent evidence and the international expertise of nurse leaders and collaborators in this field. Although recommended in most guidelines, the uptake of the role of the TAVI programme nurse is uneven across international regions. COVID-19 is further highlighting why a nurse-led central point of coordination and communication is a vital asset for patients and programmes. We propose an alternative streamlined evaluation pathway to minimize patients' pre-procedure exposure to the hospital environment while ensuring appropriate treatment decision and shared decision-making. The competing demands created by COVID-19 require vigilant wait list management, with risk stratification, telephone surveillance and optimized triage and prioritization. A minimalist approach with close scrutiny of all parts of the procedure has become an imperative to avoid any complications and ensure patients' accelerated recovery. Lastly, we outline a nurse-led protocol of rapid mobilization and reconditioning as an effective strategy to facilitate safe next-day discharge home. As the pandemic abates, TAVI programmes must facilitate access to care without compromising patient safety, enable hospitals to manage the competing demands created by COVID-19 and establish new processes to support patients living with valvular heart disease.
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Affiliation(s)
- Sandra Lauck
- Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver Canada
| | - Jacqueline Forman
- Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver Canada
| | - Britt Borregaard
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark
| | - Janarthanan Sathananthan
- Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver Canada
| | - Leslie Achtem
- Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver Canada
| | | | - Douglas Muir
- James Cook University Hospital, Middlesbrough, UK
| | | | - Amanda Smith
- Hamilton Health Sciences Centre, McMaster University, Hamilton, Canada
| | - Bettina Højberg Kirk
- Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - David A Wood
- Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver Canada
| | - John G Webb
- Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver Canada
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21
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Guimarães RB, Falcão B, Costa RA, Lopes MACQ, Botelho RV, Petraco R, Sarmento-Leite R. Acute Coronary Syndromes in the Current Context of the Covid-19 Pandemic. Arq Bras Cardiol 2020; 114:1067-1071. [PMID: 32638899 PMCID: PMC8416128 DOI: 10.36660/abc.20200358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/24/2020] [Accepted: 04/29/2020] [Indexed: 01/16/2023] Open
Affiliation(s)
| | - Breno Falcão
- Hospital de MessejanaFortalezaCEBrasilHospital de Messejana, Fortaleza, CE - Brasil
- Hospital Universitário Walter CantídeoFortalezaCEBrasilHospital Universitário Walter Cantídeo, Fortaleza, CE - Brasil
| | - Ricardo Alves Costa
- Instituto Dante Pazzanese de CardiologiaSão PauloSPBrasilInstituto Dante Pazzanese de Cardiologia,São Paulo, SP - Brasil
- Hospital Sírio-LibanêsSão PauloSPBrasilHospital Sírio-Libanês, São Paulo, SP - Brasil
| | | | - Roberto Vieira Botelho
- Instituto do Coração do TriânguloUberlândiaMGBrasilInstituto do Coração do Triângulo,Uberlândia, MG - Brasil
| | - Ricardo Petraco
- Imperial College LondonLondresInglaterraReino UnidoImperial College London,Londres, Inglaterra Reino Unido
| | - Rogério Sarmento-Leite
- Instituto de CardiologiaPorto AlegreRSBrasilInstituto de Cardiologia,Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento Porto AlegreRSBrasilHospital Moinhos de Vento Porto Alegre, RS - Brasil
- Universidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS - Brasil
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22
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Eid-Lidt G, Farjat Pasos JI. Patient care protocols and personal safety measures for health care professionals in cardiac catheterization rooms during the COVID-19 outbreak in the National Institute of Cardiology. Catheter Cardiovasc Interv 2020; 97:E686-E691. [PMID: 32478472 PMCID: PMC7300668 DOI: 10.1002/ccd.28979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/06/2020] [Indexed: 11/25/2022]
Abstract
The COVID‐19 was first described in late 2019 that quickly became a pandemic affecting every health system as we know it. The high transmissibility among humans represents a well‐known high burden of morbidity and mortality not only for cardiovascular patients but also for a higher risk between health care professionals that must deliver high‐quality care to them in any scenario, and cardiac catheterization rooms are no exception. This creates a new dilemma, minimize exposure to patients and health care professionals to COVID‐19 while maintaining high quality in cardiovascular therapeutics. In order to achieve this, several international recommendations on treatment algorithms modifications and in safety measures in the catheterization room have been published, always aiming to solve this dilemma in the best possible way. Hereby, we present a summary of the most recent treatment algorithms in the most important cardiovascular interventions (acute coronary syndromes, structural and congenital heart diseases) as well as specific safety measures with a step‐by‐step preparedness before and after any interventional procedure during COVID‐19 outbreak. The objective of this document is to inform and to train health care professionals that works in cardiac catheterization rooms on the risks as well on the plan for containment, mitigation, and response to the global situation of COVID‐19 infection in order to apply this in their own local work environments.
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Affiliation(s)
- Guering Eid-Lidt
- Department of Interventional Cardiology, Ignacio Chavez National Institute of Cardiology, Mexico City, Mexico
| | - Julio Iván Farjat Pasos
- Department of Interventional Cardiology, Ignacio Chavez National Institute of Cardiology, Mexico City, Mexico
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23
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Chieffo A, Stefanini GG, Price S, Barbato E, Tarantini G, Karam N, Moreno R, Buchanan GL, Gilard M, Halvorsen S, Huber K, James S, Neumann FJ, Möllmann H, Roffi M, Tavazzi G, Mauri Ferré J, Windecker S, Dudek D, Baumbach A. EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic. Eur Heart J 2020; 41:1839-1851. [PMID: 32405641 PMCID: PMC7239193 DOI: 10.1093/eurheartj/ehaa381] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/15/2020] [Accepted: 05/06/2020] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures.
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Affiliation(s)
- Alaide Chieffo
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | | | | | - Emanuele Barbato
- Department of Advanced Biomedical Sciences University Federico II, Naples, Italy
| | - Giuseppe Tarantini
- Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Nicole Karam
- European Hospital Georges Pompidou (Cardiology Department) and University of Paris, Paris, France
| | - Raul Moreno
- Cardiology Department, Hospital La Paz and IDIPAZ, Madrid, Spain
| | - Gill Louise Buchanan
- Department of Cardiology, North Cumbria Integrated Care NHS Foundation Trust, Cumbria, UK
| | - Martine Gilard
- Service de Cardiologie, Brest University Hospital, Brest, France
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital Ulleval, and University of Oslo, Oslo, Norway
| | - Kurt Huber
- 3Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, and Sigmund Freud University, Medical School, Vienna, Austria
| | - Stefan James
- Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Sweden
| | - Franz-Josef Neumann
- Division of Cardiology and Angiology II University Heart Centre Freiburg, Bad Krozingen, Germany
| | - Helge Möllmann
- Department of Cardiology St.-Johannes-Hospital Klinik für Innere Medizin I, Dortmund, Germany
| | - Marco Roffi
- Division of Cardiology, University Hospitals, Geneva, Switzerland
| | - Guido Tavazzi
- Department of clinical-surgical, diagnostic and pediatric sciences, Unit of anaesthesia and intensive care, Fondazione Policlinico San Matteo Hospital IRCCS, Pavia, Italy
| | | | - Stephan Windecker
- Department of Cardiology, Swiss Cardiovascular Center, University Hospital Bern, Bern, Switzerland
| | - Dariusz Dudek
- Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland and Maria Cecilia Hospital GVM, Cotignola, Ravenna, Italy
| | - Andreas Baumbach
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, Barts Heart Centre, London, UK and Yale University School of Medicine, New Haven, CT, USA
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24
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Pilato E, Manzo R, Comentale G. COVID-19 and ischemic heart disease emergencies: What cardiac surgery should expect? J Card Surg 2020; 35:1161. [PMID: 32302024 PMCID: PMC7262349 DOI: 10.1111/jocs.14556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Emanuele Pilato
- Division of Cardiac Surgery, "Federico II" University of Napoli, Napoli, Italy
| | - Rachele Manzo
- Division of Cardiac Surgery, "Federico II" University of Napoli, Napoli, Italy
| | - Giuseppe Comentale
- Division of Cardiac Surgery, "Federico II" University of Napoli, Napoli, Italy
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25
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Tarantini G, Fraccaro C, Chieffo A, Marchese A, Tarantino FF, Rigattieri S, Limbruno U, Mauro C, La Manna A, Castiglioni B, Longoni M, Berti S, Greco F, Musumeci G, Esposito G. Italian Society of Interventional Cardiology (GISE) position paper for Cath lab-specific preparedness recommendations for healthcare providers in case of suspected, probable or confirmed cases of COVID-19. Catheter Cardiovasc Interv 2020; 96:839-843. [PMID: 32223063 PMCID: PMC7228289 DOI: 10.1002/ccd.28888] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 01/19/2023]
Abstract
COVID‐19 pandemic raised the issue to guarantee the proper level of care to patients with acute cardiovascular diseases and concomitant suspected or confirmed COVID‐19 and, in the meantime safety and protection of healthcare providers. The aim of this position paper is to provide standards to healthcare facilities and healthcare providers on infection prevention and control measures during the management of suspected and confirmed cases of 2019‐nCoV infection accessing in cath‐lab. The document represents the view of the Italian Society of Interventional Cardiology (GISE), and it is based on recommendations from the main World and European Health Organizations (WHO, and ECDC) as well as from the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).
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Affiliation(s)
- Giuseppe Tarantini
- Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, Padua, Italy
| | - Chiara Fraccaro
- Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, Padua, Italy
| | - Alaide Chieffo
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | | | | | | | - Ugo Limbruno
- Dipartimento Cardio-neuro-vascolare, Azienda USL Toscana Sud-est, Ospedale di Grosseto, Grosseto, Italy
| | - Ciro Mauro
- A.O.R.N. A. Cardarelli, UOC Cardiologia, Naples, Italy
| | - Alessio La Manna
- Division of Cardiology, Dipartimento Cardio-Toraco-Vascolare e Trapianto d'organi - CAST, Policlinico Hospital, Catania, Italy
| | | | - Matteo Longoni
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Sergio Berti
- U.O.C. Cardiologia Diagnostica e Interventistica, Dipartimento Cardiotoracico, Fondazione Toscana G. Monasterio - Ospedale del Cuore G. Pasquinucci, Massa, Italy
| | - Francesco Greco
- Division of Cardiology, Ospedale Civile SS Annunziata, Cosenza, Italy
| | - Giuseppe Musumeci
- Interventional Cardiology Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
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26
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Ryalino C, Agung Senapathi T, Wiryana M, Gede Utara Hartawan IGA, Pradhana A. Perioperative safety during Covid-19 pandemic: A review article. BALI JOURNAL OF ANESTHESIOLOGY 2020. [DOI: 10.4103/bjoa.bjoa_83_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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27
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Mendis S. Cardiovascular disease in the context of the COVID-19 pandemic. INTERNATIONAL JOURNAL OF NONCOMMUNICABLE DISEASES 2020. [DOI: 10.4103/jncd.jncd_31_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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