It takes at least two years to make up for the operations that arose in heart surgery. Late diagnosis and advanced lung cancer are also a serious problem – PAP told Prof. Mariusz Kuśmierczyk of the National Institute of Cardiology in Warsaw.
As a result of this epidemic, queues for patients waiting for elective cardiothoracic surgery (performed in the chest area) have increased significantly in many centers. Both are classic open heart surgery and treatments for lung cancer. Problems related to these procedures will be the main theme of the 10th jubilee of the Polish Society of Cardio-Thoracic Surgeons, which will be held in Warsaw from 15-16 June.
Association President a. It takes at least two years to make up for operations that have arisen in heart surgery, Mariusz Kommerczyk said in an interview with PAP. Before the pandemic, these queues were generally small, because the surgery suites were operating dynamically. The COVID-19 pandemic changed everything. At the National Institute of Cardiology in Warsaw, the queue for cardiac surgery patients has doubled.
During the successive waves of the pandemic, some cardiac surgery departments were converted to covid centers and dedicated their ECMO to the needs of patients with respiratory failure. ECMOs are machines for supplying blood with oxygen that heart surgeons use in patients with heart failure. “Before the epidemic, 90 percent. In some cases, it was used in circulatory failure, and only to a small extent in patients with respiratory failure “- explains the professor. Marius Kuimerczyk.
During the SARS-CoV-2 pandemic, ECMO was primarily used to rescue COVID-19 patients. At the Hospital of the Ministry of the Interior and Administration in Warsaw, at its peak, 14 patients were connected to ECMO due to respiratory failure.
“Other centers that were not involved in the fight against COVID-19 often had to operate on an emergency basis for patients who needed immediate surgery, for example for a ruptured heart or an ascending aortic aneurysm. For example, the National Heart Institute was It’s the only one in the county. Masovian Center, which was still operating. We operated on six to ten ruptured aortas over the course of a week. Earlier, when other cardiac surgery departments were also operating, we had about 20 patients during the year” – Explains the specialist.
The President of the Polish Society of Cardio-Thoracic Surgeons emphasizes that even some elective procedures cannot be waited for a long time, for example after an acute heart attack or in the case of advanced coronary artery disease, because the patient may not have them. “Delaying the operation also means higher costs. A very long delay means that you have to repeat the diagnostic tests, for example, the result of the coronary angiography is valid for six months “- he adds.
In the case of heart surgery, among the patients waiting for surgery, the largest number are those with aortic stenosis and advanced coronary artery disease. According to the specialist, valvular surgery is especially important, since coronary artery disease can also be treated with interventional cardiology.
“During the epidemic, interventional cardiology has often replaced cardiac surgery. Aortic valve stenosis (stenosis) can be treated by interventional cardiology, but this applies in our country to elderly patients who, due to their general health condition, cannot perform surgery in the traditional way. Young patients, as well as those with other valve defects, such as mitral valve insufficiency, should undergo conventional cardiac surgery “- emphasizes Professor D. Marius Kuimerczyk.
Lung cancer treatments also declined at the end of 2020 as the number of patients was lower than usual. This does not mean that there have been fewer cases of this disease. Many patients are late to see a doctor and have not been diagnosed. “However, since the beginning of 2021, there are more and more patients with this cancer,” he adds.
Currently, more patients are made, but the serious problem is still the lack of medical personnel. “It is not only about doctors, especially surgeons and anesthesiologists, there is also a shortage of nurses who have gone to other hospitals, mainly dealing with the treatment of coronavirus” – notes Professor K. Marius Kuimerczyk.
There are fewer cardiac and thoracic surgeons than in previous years, because interest in this specialty is declining among residents. “The rash for doctors in heart surgery was in the early 90’s, most of us are now 50-60 years old. There is almost no influx of young staff because heart surgery has become unattractive. It is hard and physical work, plus it is very fun, we have a little bit of Free time. It happens that doctors are from the so-called passive employment, that is, those who have not entered other specialties and do not always deal with heart surgery “- explains the president of the Polish Society of Cardio-Thoracic Surgeons.
In his opinion, it will be difficult to compensate for the backlog in cardiovascular and thoracic surgery during a pandemic, and two years is the absolute minimum. (PAP)
Author: Zbigniew Wojtasiński
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