April 14, 2021 by Bethany Rundell
COVID Fears and Heart Surgeries: Making Progress Against Potentially Deadly Delays
An analysis of national data has found that the COVID-19 pandemic resulted in a substantial decline in overall heart surgeries across the U.S. last year, compared to 2019, according to researchers at the University of California at San Francisco.
The troubling study, which was presented at this year’s annual meeting of the Society of Thoracic Surgeons, found a 53 percent decrease in all adult heart surgeries, including a 40 percent decline in non-elective heart surgeries and a 65 percent decrease in elective heart surgeries, during the pandemic.
“It’s been a tough sell convincing people that it’s safe to go to the hospital,” explains Joseph McGinn Jr., M.D., the chief of cardiac surgery at Baptist Health’s Miami Cardiac & Vascular Institute. “The reality is that we’re really good at keeping COVID patients away from the rest of the patients. We have so many excellent protocols. The patients who undergo heart surgery are nowhere near areas where we care for COVID patients.”
He adds that “elective surgery” means “it can wait a couple of weeks, but it can’t wait a couple of months or longer — and that’s what’s happening.”
The University of California researchers looked at data from 717,103 adult cardiac surgery patients, and more than 20 million COVID-19 patients to determine how the pandemic affected adult cardiac surgery on national and regional levels. Regionally, the Mid-Atlantic area (New York, New Jersey, and Pennsylvania), was among those most affected by the COVID crisis, experiencing a 71 percent decrease in overall case volume.
The study also found an increase in fatal outcomes from heart procedures– but that’s likely because many surgeons were limited to operating on only the most urgent cases involving the sickest patients, the researchers said.
Despite the concerns stemming from this national study, Dr. McGinn points out that Baptist Health and other healthcare providers have started to make progress in convincing heart patients to move forward with elective surgeries, and not delay any emergency care if experiencing out-of-the-ordinary symptoms.
“We’re turning the corner to some degree, but many people are still afraid to come to the hospital,” said Dr. McGinn. “Our patients are typically over 65 years of age. And the 65-and-older group have gotten really hit hard by COVID — that’s where the highest mortality rates were, and many of them had comorbidities (two or more underlying diseases or medical conditions). They already had high blood pressure, diabetes, heart disease — all those are the classic type of patients that undergo heart surgery.”
The most common type of heart surgery for adults is coronary artery bypass grafting (CABG). During CABG, a healthy artery or vein from the body is connected, or grafted, to a blocked coronary (heart) artery. The blood then bypasses the blockage by going through the new graft to reach the heart muscle.
Dr. McGinn, who is renown internationally for pioneering minimally invasive cardiac bypass surgery, said he is starting to get inquiries again from out-of-state residents to schedule heart surgeries at the Institute — a sign that fears of going to the hospital for necessary procedures is starting to wane.
Dr. McGinn points out that some patients may not fully understand that “elective” surgeries cannot be put off indefinitely.
“The people who are waiting on elective surgeries — meaning they have blocked arteries — they know that they’re at risk for a heart attack,” he said. “But they’re not coming in for elective surgery and those people are eventually going to become urgent down the road. That’s our big concern — that the people who are most helped by surgery are sitting at home waiting, and that’s unfortunate.”