Cardiac Surgery During Wartime in Israel

Abstract Background A war in Israel started on 7 October 2023 and has affected all major tertiary centers in Israel. In the largest cardiac surgery department in Israel, there has been a surprising increase in the number of open-heart procedures, while approximately 50% of surgeons were recruited to military service. The purpose of this study is to characterize this increase in the number of procedures during wartime and to assess whether the crisis has affected the results. Methods Patients who underwent cardiac surgery in the first two months of the war were compared to the same period of the year before, namely from 7 October 2023 to 7 December 2022 and 2023. Results 120 patients (43.6%) were operated on in 2022, and 155 (56.4%) during wartime in 2023. This signifies a 33.0% increase in open-heart procedures (109 in 2022 vs. 145 in 2023, p-value 0.26). There were no differences in baseline characteristics of patients in the two years and no differences in intraoperative characteristics, including also the type of surgery. However, compared to 2022, there was a 233% increase in the number of transplantations (p-value 0.24). The results during wartime were similar to those of 2022, including postoperative complications, length of stay, and mortality. Conclusions Patients who underwent cardiac surgery during wartime presented similar results to those of last year and, despite the significant increase in workload, had comparable outcomes. There was a notable increase in the number of transplants this year, attributed to the unfortunate increase in organ donors.