Surgical Triage and Timing for Patients with COVID: A Guidance Statement from the Society of Thoracic Surgeons


Michael C. Grant, Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address:
Sylvain A. Lother, Department of Internal Medicine, Sections of Infectious Diseases and Critical Care, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
Daniel T. Engelman, Heart and Vascular Program, Baystate Health, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts, USA.
Ansar Hassan, Department of Cardiovascular Surgery, Maine Medical Center, Portland, ME, USA.
Pavan Atluri, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Rainer Moosdorf, Department of Cardiovascular Surgery, Phillips University, Marburg, Germany.
J Awori Hayanga, Department of Cardiovascular and Thoracic Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
HelenMari Merritt-Genore, Methodist Physicians Clinic, Omaha, Nebraska, USA.
Subhasis Chatterjee, Division of General and Cardiothoracic Surgery, Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Michael S. Firstenberg, St. Elizabeth Medical Center, Appleton, Wisconsin, USA.
Hitoshi Hirose, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jennifer Higgins, Division of Cardiovascular Surgery, St. Mary's General Hospital, Kitchener, Ontario, Canada.
Jean-Francois Legare, Division of Cardiac Surgery, New Brunswick Heart Centre, Saint John, New Brunswick, Canada.
Yoan Lamarche, Department of Cardiac Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.
Malek Kass, Division of Cardiology, University of Manitoba, Winnipeg, Canada.
Samer Mansour, Division of Cardiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
Rakesh C. Arora, Department of Surgery, Section of Cardiac Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.

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The Annals of thoracic surgery


The coronavirus disease 2019 (COVID-19) pandemic continues to disrupt the provision of cardiac procedural services due to overwhelming interval surges in COVID-19 cases and the associated crisis of cardiac intervention deferment. Despite the availability of widespread testing, highly efficacious vaccines, and intensive public health efforts, the pandemic is entering its third year where new SARS-CoV-2 variants have increased the likelihood that patients scheduled for cardiac intervention will contract COVID-19 in the perioperative period. The Society of Thoracic Surgeons (STS) Workforce on Critical Care, the Workforce on Adult Cardiac and Vascular Surgery and the Canadian Society of Cardiac Surgeons have developed this document, endorsed by the STS and affirmed by the Society of Cardiovascular Angiography and Interventions and the Canadian Association of Interventional Cardiology, to provide guidance for cardiac procedure deferment and intervention timing for preoperative patients diagnosed with COVID-19. This document is intended for the perioperative cardiac surgical team and outlines the present state of the pandemic, the impact of COVID-19 on intervention outcome, and offers a recommended algorithm for individualized cardiac procedure triage and timing.