Cardiovascular Surgery

The Cardiac Surgery Unit uses both traditional techniques and the most advanced techniques currently available for the surgical treatment of adult heart diseases in order to provide each patient with the most suitable surgery for their needs.

Coronary artery surgery

Long and consolidated experience with traditional techniques is now accompanied by mastery of the most innovative methods for the treatment of ischaemic heart disease and its acute complications:

• Coronary artery revascularization via sternotomy with the use of extracorporeal circulation (traditional intervention)
• Coronary artery revascularization via sternotomy without the use of extracorporeal circulation ("beating heart" surgery)
• Revascularization via left mini-thoracotomy (through a skin incision only a few centimetres long) without the use of extracorporeal circulation (minimally invasive coronary surgery) for the treatment of one- or two-vessel disease
• Complete coronary revascularization using only arterial conduits
• Coronary revascularization with multiple arterial "Y" anastomotic grafts without trauma to the ascending aorta (no-touch aorta)
• Treatment of acute complications of myocardial infarction: rupture of the interventricular septum, the free wall of the left ventricle, rupture of the papillary muscles
• Treatment of chronic complications of ischaemic heart disease: aneurysmectomy and reconstruction of left ventricular geometry, treatment of ischaemic mitral regurgitation.

Valve surgery

Alongside the traditional experience with placement of prosthetic heart valves, the most up-to-date and well-established techniques of valve reconstruction are performed.

Mitral valve

• Replacement of the valve with a mechanical or biological prosthesis via a sternotomy with extracorporeal circulation (traditional intervention)
• Repair and reconstruction of the valvular apparatus via a sternotomy with extracorporeal circulation using the most advanced techniques (almost all cases of mitral valve insufficiency that are treated)
• Repair and reconstruction of the valvular apparatus with extracorporeal circulation and a video-assisted technique via a right mini-thoracotomy (minimally invasive surgery)
• Repair and reconstruction of the valvular system with extracorporeal circulation and a video-assisted technique via a mini-sternotomy (minimally invasive surgery)

Aortic valve, aortic outflow region and ascending aorta

• Replacement of the valve with a mechanical or biological prosthesis via a sternotomy with extracorporeal circulation (traditional intervention)
• Repair and reconstruction of the valve via a sternotomy with extracorporeal circulation using the most advanced techniques
• Repair or replacement of the valve through a mini-access (minimally invasive surgery) with extracorporeal circulation
• Replacement via sternotomy with extracorporeal circulation using tissue taken from a cadaver (homograft)
• Valve replacement without sternotomy with implantation of a prosthetic valve through a catheter introduced via the femoral artery or ventricular apex (transcatheter aortic valve implantation, TAVI), without extracorporeal circulation (minimally invasive surgery)
• Replacement of the ascending aorta via a sternotomy with extracorporeal circulation using a prosthetic conduit or tissue from a cadaver for the treatment of acute (dissection) or chronic (aneurysm) disorders according to the most recent techniques that provide for the preservation of the native valve in selected cases
• Replacement of the aortic arch via a sternotomy with extracorporeal circulation using a prosthetic conduit

Tricuspid valve

• Replacement of the valve with a mechanical or biological prosthesis via a sternotomy with extracorporeal circulation (traditional intervention)
• Repair via a sternotomy with extracorporeal circulation
• Repair via a sternotomy with “beating heart” extracorporeal circulation without cardioplegic arrest

Surgery for arrhythmias

Daily collaboration with the electrophysiology specialist and the creation of shared diagnostic-therapeutic pathways has allowed the development of well-used procedures and the introduction and progression of innovative lines of surgical treatment:

• Surgical ablation of atrial fibrillation during cardiac surgery (valve repair/replacement, aorto-coronary bypass)
• Ablation of isolated atrial fibrillation and closure of the left atrial appendage via thoracoscopy
• Ablation of ventricular arrhythmias originating from the epicardium and the endocardium during surgical aneurysmectomy of the left ventricle
• Epicardial and endocardial ablation of congenital and acquired complex ventricular arrhythmias via a mini-thoracotomy (minimally invasive route) or sternotomy
• Biventricular pacemaker implant via a left mini-thoracotomy (minimally invasive)

Correction of congenital heart defects in the adult

Interatrial defect

• Video-assisted repair with extracorporeal circulation using the most advanced techniques via a right mini-thoracotomy (minimally invasive surgery)
• Video-assisted repair with extracorporeal circulation using the most advanced techniques via a mini-sternotomy (minimally invasive surgery)

Interventricular defect

• Video-assisted repair with extracorporeal circulation using the most advanced techniques via a right mini-thoracotomy (minimally invasive surgery)

Repeated interventions (valves, coronary arteries)

• Performed with extracorporeal circulation via percutaneous accesses and sternotomy or thoracotomy (minimally invasive)