Introductory note
Cardiovascular diseases are the most common cause of illness and death today. This has a significant impact on all aspects of our lives in social, psychological, organizational, and especially financial terms. Our obligation is to provide a cutting-edge service in the field of cardiovascular medicine in general, and specifically in the field of modern cardiac surgery practice. Efficient, high-quality, short-term cardiac surgery procedures without significant complications, enable patients to recover quickly and successfully after surgery and return to their usual lifestyle and professional activities in a short period of time, thus providing both for themselves and their families. Our Clinic provides a complete system of efficient diagnostics, treatment and postoperative recovery for patients who need cardiac surgery.
HISTORY
The Department of Vascular Surgery was established within the Clinic for General Surgery of the CHC “Dr Dragiša Mišović” in 1973. It was a predecessor of the Institute, Center, Clinic etc. of the existing Institute for Cardiovascular Diseases “Dedinje”. The first Head of the Institute for Cardiovascular Surgery was Prim. Dr. Dragoljub Adamov, an eminent surgeon who installed the first pacemaker in former Yugoslavia in 1965, just a few years after the world’s first implant. On February 1 st , 1978, Docent dr Mihailo Vučinić performed the first cardiac surgery procedure – triple coronary artery bypass grafting, and to date more than 55,000 open heart surgeries have been performed at the Clinic for Cardiac Surgery, including heart transplants and partial and total artificial heart implants
ABOUT THE CLINIC – SCOPE OF WORK
All cardiac surgery procedures in adult patients are performed at the Clinic. It has 110 beds (29 in the intensive care unit). This Clinic performs 2000 – 2500 operations annually, which places this Clinic among the leaders in Europe and the world. Almost 50% of the surgical program consists of the most complicated cardiac surgery procedures, which are performed only in the most eminent centers in the world. In recent years, extraordinary results have been recorded in terms of the number of complications and adverse outcomes of surgery. Our team consists of experienced cardiac surgeons with several thousand procedures done, as well as junior surgeons who already have vast experience in operating on the most difficult patients, but also a large number of young, ambitious and excellent surgeons who will become a worthy replacement for the senior surgeons. The change of generations at our Clinic has always been an insensitive and extremely efficient process, which has never affected the results achieved. The clinic is focused on several programs: less invasive or minimally invasive procedures in cardiac surgery (primarily in heart valve surgery), mechanical support surgery in patients with end-stage heart failure (partial and/or total artificial heart), as well as multiple and/or total arterial revascularization of the heart, which put the Institute on the map of world cardiac surgery by participating in an extensive, international, multicenter study – ROMA study. In addition, reconstructive procedures in mitral and aortic valve replacement surgery have been a part of the program that has been developed at our Clinic for many years, with extraordinary early and long-term results.
ORGANIZATIONAL STRUCTURE
The Clinic for Cardiac Surgery has the following organizational units:
LIST OF PROCEDURES
- Revascularization of ischemic myocardium (bypass surgery of narrowed or closed blood vessels of the heart using venous and / or arterial grafts)
- Replacement of damaged heart valves (installation of artificial valves, mechanical or those made of natural materials)
- Reconstruction of damaged heart valves (mitral, aortic and tricuspid) with standard, less invasive, or minimally invasive approach
- Endoscopic mitral valve surgery
- Foreseen reconstructive procedures on the thoracic aorta, aortic arch and/or descending thoracic aorta
- Emergency procedures after dissection (rupture) of the thoracic aorta
- Procedures for the reconstruction of congenital heart defects in adult patients (over 18 years of age)
- Application of temporary cardiac function support (intra-aortic balloon pump, ECMO)
- Implantation of partial or total artificial hearts (in patients with end-stage myocardial infarction)
- Hybrid procedures on the aortic arch (combined cardiac surgery and invasive radiological procedure of graft implantation in patients with thoracic aortic dilatation).
MOST SIGNIFICANT RESULTS
- Mitral valve reconstruction procedures performed in several thousand patients (since 1985), which is one of the largest and longest surgical series in the world
- Use of arteria radialis in surgical revascularization of ischemic myocardium since 1999 when very few surgeons in the world believed in the long-term value of this graft
- Outstanding results in the surgical treatment of acute ascending aortic dissections with the use of deep hypothermic arrest, as well as an exceptional program of reconstructive thoracic aortic surgery with outstanding results achieved in recent years.
- A huge number of procedures (more than 55,000 in total), more than 2,000 performed annually (which is among the best results achieved in Europe and the world in the field of cardiac surgery).
- Permanent introduction of new procedures, primarily less and minimally invasive procedures in heart valve surgery.
- Placement of the first artificial heart in this region (Heart-Mate I, 1995).
- Extremely successful, but unfortunately cancelled, heart transplant program (the last patient operated on is still alive 22 years after surgery).
- In the last 3 years, 1 total and 22 partial artificial hearts were implanted, thus helping achieve extremely early and long-term survival rate of 95.5%.
- Successful program of hybrid procedures performed on the aortic arch.
- The first endoscopic heart surgery performed in Serbia (2011, Port Access mitral valve reconstruction).
- Huge number of published papers in eminent and very prestigious professional journals with an impressive impact factor (HEJM, Circulation, Ann Thorac Surg, ITCVS, JCC, EJCTS, etc.)
- Participation in large multicenter, multinational clinical studies, which resulted in the recognition of our Clinic as the one performing superior cardiac surgery (ROMA study, CMIC I study)
- Education of a large number of young cardiac surgeons over the last 20 years, capable of performing even the most complex cardiac surgery procedures with outstanding results. We believe that this is the best way to pay our debts to our teachers and those who had the vision and strength to lay the foundations and bear the heavy burden of the onset of cardiac surgery in this region.