At the start of the COVID-19 pandemic, heart surgeons warned that fewer people were coming in for bypass operations, valve replacements, and other cardiac procedures, in some cases dying as a result.
In a new nationwide analysis, researchers determined that the consequences may have been even worse than many realized — particularly in hard-hit hot spots in New Jersey, New York, and Pennsylvania.
During April, the number of heart surgeries plunged by 71% in those three states and by 53% in the country as a whole, when compared with monthly averages in 2019.
And those who did undergo heart surgery were less likely to survive it, according to the analysis, drawn from comprehensive data collected by the Society of Thoracic Surgeons.
The study did not identify reasons for the lower survival rates, but two explanations are likely, said lead author Tom C. Nguyen, chief of cardiothoracic surgery at the University of California-San Francisco:
Patients who did undergo surgery may have waited before seeking medical attention due to concern about the coronavirus — potentially resulting in worse outcomes, he said. And in those three Northeastern states, many hospitals were struggling to cope with the first surge of COVID-19, in some cases diverting intensive-care beds and personnel who were normally assigned to heart surgery and other complex medical conditions.
“Cardiac surgery is complicated,” he said. “There’s a routine and a cadence in what we do that involves a lot of moving parts. Sometimes, all it takes is for one or two parts to be off-axis, and other things can break down pretty quickly.”
Heart surgeons at two Philadelphia-area health systems said they saw no decline in their patient survival rates, yet agreed that the drop in the number of surgeries was unmistakable.
Delaying surgery might have been OK in some nonemergency cases, provided that those patients came in later in the year to get it done, said Paul Burns, chair of cardiothoracic surgery at Deborah Heart and Lung Center, in Browns Mills, Burlington County. And sure enough, heart-surgery numbers have rebounded at Deborah and elsewhere in the region since April.
But the increase has not been enough to make up for the sharp drop in that first month, Burns said. That suggests some people never made it to the hospital.