Advances in Cardiothoracic and Vascular Surgery in the COVID-19 Era II

Dear Colleagues,

Over the past two years, the COVID-19 pandemic has caused unprecedented problems for all health systems around the world. The severe acute respiratory syndrome caused by this infection (SARS-CoV-2) also affects patients with cardiovascular and thoracic surgical pathology, sometimes worsening their prognosis in the short and immediate term.

Due to lung damage, but also the inflammatory condition generated, the results of the operations in these patients came into question. It has become clear that patients with cardiovascular and thoracic pathology should not be operated on for the duration of the infection and the course of COVID pneumonia.

However, there are situations when these operations cannot be avoided: acute aortic dissection, infectious endocarditis with valvular vegetation at risk of embolism, unstable angina due to surgical coronary lesions, etc.

In these cases, it was considered opportune by some groups to postpone the intervention until the inflammatory syndrome decreased and negative virological test results were obtained.

However, it has been proven that inflammation, endothelial dysfunction, hypercoagulation and the tendency for intravascular thrombosis obscure the prognosis of these patients, especially in elderly patients with associated comorbidities such as obesity, diabetes, chronic obstructive pulmonary disease or hypertension.

A link has been shown between the angiotensin 2 conversion enzyme and SARS-CoV-2 in the myocardium, which generates myocarditis with immediate consequences, especially in patients with cardiovascular and thoracic surgical pathology.

In this context, knowing the particularities of these patients and their evolution can generate concepts and guidelines that will improve patient outcomes and decrease mortality.

Given the clinical significance of this topic and its impact on clinical practice and public health, Medicina is launching a Special Issue entitled “Advances in Cardiothoracic and Vascular Surgery in the COVID-19 Era II” with the aim of delivering new insight into the impact of the COVID-19 pandemic on cardiovascular management and outcomes for patients with underlying cardiovascular disease.

Prof. Dr. Horaţiu Moldovan
Guest Editor

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• COVID-19
• SARS-CoV-2
• cardiothoracic surgery
• vascular surgery
• COVID pneumonia
• cardiovascular disease
• heart valve disease
• acute aortic dissection