COVID-19 presenting after Elective Off-pump Coronary Artery Bypass Grafting and Lessons Learned

Springer Science and Business Media LLC - Tập 74 Số 1 - 2022
Sudipto Bhattacharya1, Ashok Bandyopadhyay1, Satyabrata Pahari1, Sankha Das2, Asim Kumar Dey1
1Department of Cardiothoracic and Vascular Surgery, Peerless Hospitex Hospital & B K Roy Research Centre, Kolkata, India
2Department of Anaesthesiology, Peerless Hospitex Hospital & B K Roy Research Centre, Kolkata, India

Tóm tắt

Abstract Background Cases of COVID-19 presenting after elective cardiac surgery are rare. Published literature suggests that such cases have a high morbidity and mortality rate. Here, we report a case of COVID-19 presenting after an elective, isolated off-pump coronary artery bypass (OPCAB). Case presentation A 65-year-old obese, hypertensive, hypothyroid lady, with moderate left ventricular dysfunction, presenting with unstable angina, tested negative for COVID-19 at admission, having undergone thrombolysis for a recent inferior wall myocardial infarction, at an outside centre, and coronary angiography revealing left main triple vessel disease, developed signs and symptoms of COVID-19, four days after OPCAB. She was diagnosed with moderate COVID-19 infection. Subsequent contact tracing revealed that her husband was suffering from mild COVID-19 infection and was managed in home isolation. Isolation and early supportive management with moist oxygen, steroids, intravenous antibiotics, zinc and vitamin C helped the patient recover. She was followed up at one month, six months, one year and at eighteen months and has been doing well. Conclusions A strong clinical suspicion and repeat testing for COVID-19 is required as the diagnosis may often be missed with COVID-19 mimicking the signs and symptoms of post-cardiotomy syndrome. Preferentially dealing with such cases off-pump, thereby avoiding cardio pulmonary bypass-related complications, may improve outcomes. Isolation and early supportive management help. Adequate follow-up is required in all such cases as cardiovascular complications are common, alongside known long-term sequelae, like anxiety, depression, cardio-respiratory complications, venous thromboembolism and even postural orthostatic tachycardia syndrome.

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Tập 74 Số 1

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