Way forward for Cardiothoracic Surgery in COVID Era

Dr KM Cherian,

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COVID 19 Pandemic has indeed dynamically changed the healthcare system, especially with a lot of limitations on access to healthcare facilities. Many patients have postponed their surgeries, not elective ones but even the ones that need immediate attention. Those with pre-existing conditions and are not visiting the hospitals even for their routine check-ups, due to the fear of being exposed to the virus. We have seen reports and read stories on how people have lost their lives due to a Heart Attack/Stroke, with symptoms being prominent, but due to the fear of COVID, they did not go out and seek professional help.

It is a vicious cycle, because a heart related ailment or condition is a co-morbid condition and according to reports, most of the deaths occurred in COVID infected individuals were the ones with co-morbid conditions. However, since such persons are more vulnerable, they fear venturing out, even if it is to seek general medical attention.

With that being said, it is also impossible for high-risk heart patients with severe conditions to not undergo surgeries. When it is essential depending on the conditions, patients might have to opt for it. SOPs for various activities are being put in place at hospital for treatment in COVID era. The admission process itself is done only after getting clearance of COVID-19 infection via Lab tests. Regular temperature checks are conducted on everyone entering and exiting the hospital building. Unless absolutely necessary, patient- attenders are asked to go back home. Many hospitals have also put strict restrictions on visitors.

Heart surgeries are gruelling and long procedures taking a toll on a patient’s both physical and mental health alike. Open-heart surgeries are not affordable for everyone and procedures last for days. Apart from that,in the COVID era, there is a dire need for minimum contact, which is possible through minimally invasive surgical techniques, since the surgical team has to be careful not to get infection; all the precautionary measures that are being practised are also very hardest on the team.

Procedures such as TAVR/TAVI (Trans catheter aortic valve replacement/ implantation) are aemerging procedures in minimally invasive heart procedure scenes. Many case studies have already established that such procedures are absolutely safe and also have a huge success rate. Moreover, the procedure is economic for the patient whilst the recovery time being significantly lesser than that of a conventional heart operation.

With the pandemic changing the world’s lifestyle, we are progressing towards a ‘Phygital’ era, where technology will play a crucial role. Tools that support virtual care and diagnosis can be fruitful patients with heart disease. They also aid doctors in their efficiency.The branch of telemedicine specially for cardiac patients is known as telecardiology. Itaims to monitor patients real-time for irregularities andoffer remote diagnosis. This technology will be useful for treatment of heart diseases such as congestive heart failure, cardiac arrest and arrhythmia.

Telemedicine removes the barriers of transportation and requirement of physical presence to submit initial data/details. Many a time’s unavailability of doctors for consultation also tends to create anxiety in patients. With the telemedicine technology, doctors are just a click away and available for advice 24×7.

According to the Innovation Accelerator play book, the following is very evident in the next couple of years. mRNA will be a medical revolution, it might cure life threatening liver and kidney diseases. There are 3 drugs that are undergoing clinical trials currently. Medical companies with sophisticated technology will revolutionize the surgical treatment especially using Robotic Technology.

Thus, even though we all have suffered the covid-19 pandemic and believing the future is bleak, it may not be so and the optimism is that in the next 2 years, innovation in all areas will make sure that we might progress much more than what was during the last 20 years. Companies like Amazon & Google are using big data and analytics to predict the spread and also check for potential threats in non-communicable diseases such as Diabetes, Heart diseases, etc.

There is a famous English proverb, – ‘Necessity is the mother of all inventions.’ While, the global pandemic caused by the Corona Virus has led to lot of disruptions across the globe, it has also brought out the best of technology and inventions for the advancement of medical sciences.

(The author is Chairman and CEO, Frontier Lifeline Hospital. The article is for informational purposes only. Please consult experts and medical professionals before starting any therapy or medication. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)