Cardiac surgery transformation throughout the COVID-19 era: analysis of 12,409 patients
Irish Journal of Medical Science, cilt.195, sa.1, ss.65-74, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 195 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11845-025-04147-4
- Dergi Adı: Irish Journal of Medical Science
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.65-74
- Anahtar Kelimeler: COVID-19, Cardiac surgery, Demographics, Pandemic recovery, CABG, Valve surgery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Previous studies documenting COVID-19’s impact on cardiac surgery have been limited by short observation periods, small sample sizes, and lack of recovery pattern analysis. Aim: This study aims the comprehensive analysis of complete pandemic cycles, utilizing Türkiye’s graduated restriction model as a natural experiment to examine cardiac surgery transformation and recovery patterns. Methods: We conducted a retrospective analysis of 12,409 consecutive patients from March 2018 to February 2024, encompassing three equal 24-month periods: pre-pandemic, pandemic, and postpandemic. Our institution maintained non-COVID status throughout the pandemic. The pandemic period was subdivided into three phases by restriction severity (early, intermediate, late) to analyze adaptation patterns. Results: Among 12,409 patients, emergency surgery rates doubled during pandemic (6.5%→12.7%, p <0.001). CABG procedures became dominant (64.2% vs 57.3%, +6.9 percentage points, p <0.001) while valve surgery declined (-4.8 percentage points). Although overall patient age increased (+1.0 years, p <0.001), isolated CABG patients showed minimal progression (+0.4 years), revealing age increases were driven by deferred non-CABG procedures. BMI remained stable across periods (p =0.291). Emergency rates peaked during early pandemic (14.4%) before gradual recovery. Postpandemic period demonstrated successful recovery with valve surgery reaching unprecedented levels (p <0.001). Conclusions: This represents one of the largest single-center series (12,409 patients over 72 months) and provides insights that may inform future pandemic preparedness strategies in cardiac surgery. The successful post-pandemic recovery validates graduated restriction strategies over complete service suspension, offering critical insights for maintaining CABG capacity while implementing systematic valve surgery backlog management strategies during future health emergencies.