Introducción y objetivos: La pandemia de COVID-19 causada por infección del virus SARS-CoV-2 ha puesto en una situación de sobrecarga grave al sistema sanitario español. Como consecuencia se ha visto afectada la atención de las enfermedades cardiovasculares. Queremos cuantificar a nivel estatal el impacto de la pandemia en el número de las intervenciones quirúrgicas, para poder planificar la nueva normalidad postpandemia. Métodos: A instancias de la Sociedad Española de Cirugía Cardiovascular y Endovascular se envió una encuesta telemática anónima de 10 preguntas a todos los Jefes de Servicio de España. El período de estudio fue entre el 1 de enero de 2020 y el 30 de septiembre de 2020 (9 meses), y como período control las mismas fechas del año 2019. Resultados: Se recibieron los datos de 32 Centros Hospitalarios. Un 22% del total de cirujanos cardiovasculares se contagiaron de COVID19, siendo la media de 1.3 ± 1.5 adjuntos infectados/centro. Hubo fallecidos en lista de espera en el 46% de los Centros, con una media de 1.5 ± 3.6 pacientes/Centro. Hubo un descenso global del 13% en el número de cirugías (43 menos de media/centro respecto a 2019), desde una mediana de 300 (230-444) en 2019 y de 253 (172-389) en 2020 (p=0.03) con un incremento del 12% ( +7 pacientes /centro, p=0,68) en las listas de espera. Conclusiones: existió un descenso global de cirugías del 13% respecto a 2019, con un incremento del 12% en las listas de espera. El 22% de los cirujanos se contagiaron de COVID19.

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Evaluation of right ventricular (RV) function after tricuspid valve surgery is complex. The objective was to identify the most appropriate RV function parameters for this purpose. This prospective study included 70 patients undergoing cardiac and tricuspid valve (TV) surgery. RV size and function parameters were determined at 3 months and 1-year post-surgery. Categorical variables were analyzed with the McNemar test and numerical variables with the Student’s t-test for related samples or, when non-normally distributed, the Wilcoxon test. Spearman's rho was used to determine correlations between variables at 3 months and 1 year. RV diameters were reduced at 3 months post-surgery and were then unchanged at 1 year. Tricuspid annular plane systolic excursion (TAPSE) and S′ wave values were worse at 3 months and then improved at 1 year (t-score-2.35, p 0.023; t-score-2.68; p 0.010). There was no significant reduction in free wall longitudinal strain (LS) or shortening fraction (SF) at 3 months (t-score 1.421 and − 1.251; p 0.218 and 0.172), and they were only slightly below pre-surgical values at 1 year. No relationship was found between RV function parameters and mortality or major complications. During the first few months after TV surgery, LS may be a more appropriate parameter to evaluate global ventricular function in comparison to TAPSE. At 1 year, good correlations are observed between TAPSE, S′ wave, and LS values.

IntroductionRecurrent tricuspid regurgitation (TR) is frequently observed after cardiac surgery; however, the correct approach remains controversial. We developed an algorithm for action on the tricuspid valve (TV) and conducted a 1-year follow-up study. The aim was to assess the efficacy of the algorithm to minimise residual TR after TV surgery. The hypothesis was that the TR rate at 1 year would be reduced by selecting the surgical approach in accordance with a set of preoperative clinical and echocardiographic variables.MethodsA prospective, observational, single-centre study was performed in 76 consecutive patients with TV involvement. A protocol was designed for their inclusion, and data on their clinical and echocardiographic characteristics were gathered at 3 months and 1-year postsurgery. The treatment of patients depended on the degree of TR. Surgery was performed in all patients with severe or moderate-to-severe TR and in those with mild or moderate TR alongside the presence of certain clinical or echocardiographic factors. They underwent annuloplasty or extended valve repair when the TV was distorted. If repair techniques were not feasible, a prosthesis was implanted. Residual TR rates were compared with published reports, and predictors of early/late mortality and residual TR were evaluated.ResultsTR was functional in 69.9% of patients. Rigid ring annuloplasty was performed in 35.7% of patients, De Vega annuloplasty in 27.1%, extended repair in 11.4% and prosthetic replacement in 25.7%. TR was moderate or worse in 8.19% of patients (severe in 3.27%) at 1 year postintervention. No clinical, surgical or epidemiological variables were significantly associated with residual TR persistence, although annulus diameter showed a close-to-significant association. Total mortality was 12.85% for all causes and 10% for cardiovascular causes. In multivariate analysis, left ventricular ejection fraction was related to both early and late mortality.ConclusionsSevere residual TR was significantly less frequent than reported in other series, being observed in less than 4% of patients at 1-year postsurgery.

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