Coronary Artery Bypass Grafting complicated by post-operative coronavirus infection – two similar presentations with dissimilar outcomes

Alexis Redding, Harideep Samanapally, Mike O. Udoh, Jiapeng Huang, Mark S. Slaughter, Siddharth Pahwa


Patients diagnosed with COVID-19 infection undergoing surgical procedures have been reported to have increased post-operative complications and mortality. These findings are important when considering cardiac surgical procedures, specifically coronary artery bypass grafting (CABG) during this pandemic, since the Society of Thoracic Surgeons (STS) describes most of these operations as ‘urgent’. In addition, the majority of cardiac surgical patients are at increased risk of infection and death with COVID-19, as they are frequently of old age, obese, hypertensive, and diabetic, with severe cardiac or pulmonary diseases. This case series describes the clinical course following a CABG procedure in two patients that went on to develop COVID-19 infection post-operatively. We aim to illustrate the similarities in clinical presentation, but differences in eventual outcomes for both patients and hypothesize the reasons for the differences.


Coronavirus; cardiac surgery; post-operative complications; ECMO

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Søreide K, Hallet J, Matthews JB, et al. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg. 2020; 107(10):1250-1261. doi: 10.1002/bjs.11670.

Aziz H, Filkins A, Kwon YK. Review of COVID-19 Outcomes in Surgical Patients. Am Surg. 2020; 86(7):741-745. doi: 10.1177/0003134820934395.

Knisely A, Zhou ZN, Wu J, et al. Perioperative Morbidity and Mortality of Patients With COVID-19 Who Undergo Urgent and Emergent Surgical Procedures. Annals of surgery. 2021; 273(1):34–40. doi: 10.1097/SLA.0000000000004420.

Nguyen TC, Thourani VH, Nissen AP, et al. The Effect of COVID-19 on Adult Cardiac Surgery in the United States in 717 103 Patients. Ann Thorac Surg. 2021: S0003-4975(21)01310-2. doi: 10.1016/j.athoracsur.2021.07.015.

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.

Yates MT, Balmforth D, Lopez-Marco A, et al. Outcomes of patients diagnosed with COVID-19 in the early postoperative period following cardiac surgery. Interact Cardiovasc Thorac Surg. 2020; 31(4):483-485. doi: 10.1093/icvts/ivaa143.

Arevalo-Rodriguez I, Buitrago-Garcia D, Simancas-Racines D, et al. False-negative results of initial RT-PCR assays for COVID-19: A systematic review. PloS one. 2020; 15(12):e0242958. doi: 10.1371/journal.pone.0242958.

Montes FR, Maldonado JD, Paez S, et al. Off-pump versus on-pump coronary artery bypass surgery and postoperative

pulmonary dysfunction. J Cardiothorac Vasc Anesth. 2004; 18(6):698-703.

Mustafa AK, Alexander PJ, Joshi DJ, et al. Extracorporeal Membrane Oxygenation for Patients With COVID-19 in Severe Respiratory Failure. JAMA Surg. 2020; 155(10):990-992. doi: 10.1001/jamasurg.2020.3950.


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ISSN: 2360-6975