The coronavirus-disease 2019 (COVID-19) pandemic imposed an unprecedented burden on the provision of cardiac surgical services. The reallocation of workforce and resources necessitated the postponement of elective operations in this cohort of high-risk patients. We investigated the impact of this outbreak on the aortic valve surgery activity at a single two-site centre in the United Kingdom. Data were extracted from the local surgical database, including the demographics, clinical characteristics, and outcomes of patients operated on from March 2020 to May 2020 with only one of the two sites resuming operative activity and compared with the respective 2019 period. A similar comparison was conducted with the period between June 2020 and August 2020, when operative activity was restored at both institutional sites. The experience of centres world-wide was invoked to assess the efficiency of our services. There was an initial 38.2% reduction in the total number of operations with a 70% reduction in elective cases, compared with a 159% increase in urgent and emergency operations. The attendant surgical risk was significantly higher [median Euroscore II was 2.7 [1.9–5.2] in 2020 versus 2.1 [0.9–3.7] in 2019 (p = 0.005)] but neither 30-day survival nor freedom from major post-operative complications (re-sternotomy for bleeding/tamponade, transient ischemic attack/stroke, renal replacement therapy) was compromised (p > 0.05 for all comparisons). Recommencement of activity at both institutional sites conferred a surgical volume within 17% of the pre-COVID-19 era. Our institution managed to offer a considerable volume of aortic valve surgical activity over the first COVID-19 outbreak to a cohort of higher-risk patients, without compromising post-operative outcomes. A backlog of elective cases is expected to develop, the accommodation of which after surgical activity normalisation will be crucial to monitor.

中文翻译：

---

COVID-19 大流行对主动脉瓣手术服务的影响：单中心经验

2019 年冠状病毒病 (COVID-19) 大流行给心脏外科服务的提供带来了前所未有的负担。劳动力和资源的重新分配需要推迟这群高危患者的择期手术。我们在英国的一个单一的两中心中心调查了这次疫情对主动脉瓣手术活动的影响。从当地手术数据库中提取数据，包括在 2020 年 3 月至 2020 年 5 月期间接受手术的患者的人口统计学、临床特征和结果，其中两个站点中只有一个恢复了手术活动，并与各自的 2019 年期间进行了比较。对 2020 年 6 月至 2020 年 8 月期间进行了类似的比较，当时两个机构都恢复了运营活动。世界各地中心的经验被用来评估我们服务的效率。手术总数最初减少了 38.2%，选择性病例减少了 70%，而紧急和紧急手术增加了 159%。随之而来的手术风险显着更高 [2020 年 Euroscore II 中位数为 2.7 [1.9-5.2]，而 2019 年为 2.1 [0.9-3.7] (p = 0.005)]，但既不是 30 天生存率，也不是无重大术后并发症（因出血/填塞、短暂性脑缺血发作/中风、肾脏替代疗法而再次胸骨切开术）受到影响（所有比较 p > 0.05）。在两个机构站点重新开始活动使手术量在 COVID-19 之前时代的 17% 以内。在第一次 COVID-19 爆发期间，我们的机构设法为一组高风险患者提供了大量的主动脉瓣手术活动，而不会影响术后结果。预计会出现积压的选择性病例，手术活动正常化后的适应将是监测的关键。