COVID-19 Testing, Surgical Prioritization, and Reactivation in a Congenital Cardiac Surgery Program

The global emergence and rapid spread of COVID-19 has forced surgical specialties to overcome unprecedented operational challenges. Surgeons share the responsibility of prioritizing operations to conserve protective equipment, ventilators, and personnel. The subspecialty of congenital cardiac surgery must consider factors unique to its patient population when triaging, including the narrow temporal window in which many neonatal operations are optimally performed. Stephens and colleagues have published crisis management strategies that recommend universal preoperative screening and provide guidance for surgical prioritization of congenital cardiac surgery patients. These strategies are supported by the Society of Thoracic Surgeons, American Association of Thoracic Surgeons, and the Congenital Heart Surgeons’ Society. Here, we present our four-month experience with universal preoperative COVID-19 testing, surgical prioritization, and eventual reactivation in a university-based congenital cardiac surgery program.

In summary, our institutional experience demonstrates that the implementation of universal COVID-19 screening, surgical prioritization, and eventual reactivation is feasible for congenital cardiac surgery programs. As programs across the nation cautiously reactivate, this must be done while monitoring for local COVID-19 resurgence and/or institutional resource limitations that may require reversion back to a surgical prioritization strategy. Finally, while the prevalence of COVID-19 in congenital cardiac surgery patients is very low, universal preoperative COVID-19 testing should be continued, with rare exceptions, as recommended by our governing societies.