Waiting longer, getting sicker: Cardiologists reveal ballooning waits for surgery in B.C.

The province's cardiologists are revealing that virtually every patient waiting for a scheduled heart surgery in British Columbia is waiting beyond their federally recommended wait time to go under the knife. That means patients are getting sicker and needing emergency care more often.

All cardiac surgery patients begin their immediate recovery in intensive care units, but with a flood of COVID-19 patients starting with the Delta wave last summer and continuing with the Omicron wave late last year, only the most serious of heart patients have had surgery. 

"In the past, it's been patients that were relatively elective that were waiting, but now even relatively urgent patients that should be going quickly are seeing that their wait times are increasing and are also exceeding their recommended wait times," explained Dr. Daniel Wong, head of cardiac surgery for the Doctors of B.C.

“Say there's only four spots on the lifeboat, you have to take the four people that you can and there's many others waiting and it's becoming more and more challenging to find out who's the highest priority when everyone’s high priority.”

Wong says while urgent bypass surgeries have continued essentially uninterrupted, there are approximately 400 patients waiting for a scheduled open-heart surgery. Of those, 58 per cent are exceeding the recommended wait time for the major procedure.

There are many other categories of heart surgery, as well, each with different priority levels and acceptable wait times. The vast majority of patients in each group are exceeding their recommended wait times, and they’re all waiting roughly twice as long as they used to before the Delta wave, according to Wong.

“It’s unprecedented,” said Wong. “There were very few people who waited beyond the recommended wait time before and now it's starting to become a huge number."

RISKIER FOR PATIENTS AND A BIGGER STRAIN ON THE SYSTEM

The longer a patient waits for heart surgery, the weaker they become, and that makes the surgery riskier, with a longer recovery. Wong described a typical ICU stay as taking several days, but said it could take upwards of two weeks when the patient has weakened after waiting too long.

Intensive care is much costlier to the system, as are emergency department visits for patients whose symptoms worsen as they wait for surgeries that keep getting delayed. 

NO EASY ANSWERS IN ADDRESSING LONG WAITS

CTV News asked the health minister how quickly he expects delayed or postponed surgeries to get back on track now that COVID-19 hospitalizations due to the Omicron variant are decreasing.

“We're going to be aggressively moving to rebook surgeries in the coming weeks," said Adrian Dix. “We've demonstrated every time surgeries have been interrupted or delayed during the pandemic we're right on it, getting those surgeries rebooked and that is happening in many places across the province."

That promise comes as radiologists urge Dix to invest in accelerated medical imaging to prepare for those surgeries, anaesthesiologists ask for greater transparency around where and when the bottlenecks are happening, and general surgeons ask for a seat at the table to help plan the fastest route to catching up on postponed procedures.

When it comes to cardiac surgeries, Wong warns staffing hasn’t changed, and that will limit how many procedure they can perform: There simply aren’t enough qualified medical personnel available to do the highly specialized work of intensive care, perfusion and myriad other supports required for cardiology.

“We’re essentially running at red line constantly,” he said, pointing out that even before the pandemic, there was no downtime.

“We don't have a huge capacity to increase additional surgical procedures, so we can't really make up for lost time.”