- Biggest threat to CHD during the COVID-19 era is the distinct lack of resources usually in ICUs, but are instead being used for regular COVID-19 care
- Now when performing surgeries for CHD, hospitals must keep a lot more things in mind besides the surgery in order to keep patients as safe as possible
- Timing for surgery must be scheduled around a lot outside factors than ever before and surgeries must be delayed if not all elements of care may be planned in advance 
- Additionally, minimizing patient hospitalization is now a major factor of patient treatment and may lead doctors to deviate from originally planned procedures

Ohio State University, Columbus

- This paper provides general guidance to facilities that are faced with making decisions on how to change their protocol for genital heart surgery
- It has been broken up into a few sections that discuss the following: Triage of Surgical Patients, Preserving the Workforce and Regional Collaboration, Preserving the Workforce and Regional Collaboration, COVID-19 Exposure and Social Distancing, Role of Congenital Cardiac Surgeons in the Care of COVID-19–Positive Noncardiac Patients, as well as a couple sections which discuss the training of new surgeons and the importance of mental resilience
- Congenital heart disease will be referred to as CHD on all child posts

COVID-19: Crisis Management in Congenital Heart Surgery

Citation:   Stephens, E. H., Dearani, J. A., Guleserian, K. J., Overman, D. M., Tweddell, J. S., Backer, C. L., Romano, J. C., & Bacha, E. (2020). COVID-19: Crisis Management in Congenital Heart Surgery. World Journal for Pediatric and Congenital Heart Surgery, 11(4), 395–400. https://doi.org/10.1177/2150135120931398

URL: https://journals.sagepub.com/doi/full/10.1177/2150135120931398#articleCitationDownloadContainer

Triage of Surgical Patients

- Facilities should primarily focus on protecting staff specific to CHD surgery as they are a very limited resource in almost all facilities
- Surgeons specifically should be under close health monitoring in order to avoid infection as they are invaluable to the team
-  Regional collaboration with other nearby facilities should be considered as small programs are at huge risk if there is an infect staff member present
- All CHD facilities should operate in a total patient care-oriented mindset and collaborate in order to provide the best care possible to all patients


Preserving the Workforce and Regional Collaboration

- All visits should have increased planning in order to optimize both the brevity of the visit as well as information gathering in order to avoid forgetting any details which would require a second visit and increase physician or patient risk

Surgical Consultation and Clinic Visits

- Possibility of patient exposure to COVID-19 should be considered during the treatment process as man patients with CHD are comorbid with other conditions which make them more susceptible respiratory issues
- This paper is specifically directed toward child patients, so the paper discusses the possibility of siblings infecting each other as well as the use of only 1 parent for bedside care in order to limit exposure to the patient
- Ideally, COVID-19 tests would be performed prior to operation of all patients as well as their parents however due to limited resources this may not entirely be possible


COVID-19 Exposure and Social Distancing

- CHD surgeons should also be able to assist with care of COVID-19 positive patients if needed as they have the skills to provide extracorporeal membrane oxygenation (ECMO) support
- There must be extreme caution on the side of the facility however to limit exposure as much as possible


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