CARDIOVASCULAR SURGERY AND CARDIOLOGY CENTER

CARDIOVASCULAR SURGERY

Cardiovascular surgery clinic renders services by an experienced team using high-tech equipment, also including a five-bed intensive care unit.

Services rendered:

• Coronary Heart Diseases – Coronary By-pass Surgeries

• Heart Valve Diseases – Valve Repair Surgeries – Valve Replacement Surgeries

• Aneurysm, Perforation and Stenosis in Greater Vessels

• Cardiac Tumor Surgeries

• Non-surgical treatment of Aortic Aneurysm Diseases, such as EVAR/TEVAR, with stent and graft

• Stent Implantation for Greater Vessels

Vascular Surgery;

• Carotid Endrterectomy and Stent Implantation or By-pass

• Extra-anatomic By-pass

• Repair of Peripheral Artery/Vein Injuries

• Aorto-Iliac Femoral Bypass

• Repair of Aneurysm of Abdominal Aorta

• Y Graft in Aorto-Iliac Obstructions

• Aortorenal Bypass – Stent

• Mesenteric Arterial Reconstruction – Stent

• Surgical treatment of Coarctation of Aorta

• Stent and Atherectomy Surgeries / Interventions in Greater and Lesser Peripheral Arteries

IT IS SAFER THAN ENDOVASCULAR STENT IMPLANTATIONS AND AORTIC SURGERIES

Before endovascular aneurysm repair (EVAR) was introduced to the clinical practice, “thoracoabdominal aortic an­eurysm surgeries” have been difficult for both patients and surgeons and associated with high mortality and com­plication rates. For those aneurysms that develop in patients, who are usually at advanced age or have serious co­morbidites such as heart, lung and kidney conditions, left intercostal and/or median abdominal incisions would have been made. Those conventional surgery techniques were not only taking long hours, but they were also accompanied by very long hospital stays and conditions related with all organs.

In EVAR method, general anesthesia is induced and patient is transferred to the angiography room for interven­tion. Intervention starts with a 4- to 5-cm skin incision and preparation of artery(ies) at the inguinal locus. Surgical intervention ends with this procedure and next, a synthetic woven fabric that is wrapped around the stent is placed through guide wires that are advanced through vessels, such that aneurysm is completely covered along with a safe zone before and after the aneurysmatic segment. Stent is deployed in the aorta, while it is located between two ends of aorta with normal calibration.

Accordingly, blood circulation in the aneurysmatic, dissected or even ruptured aortic segment is bypassed. At the same time, blood supply is supplied to end organs through the lumen of the stent.

ADVANTAGES OF ENDOVASCULAR TREATMENT

EVAR procedure takes far shorter time and lesser skin incision is made. No bone is divided and patients’ recovery time is significantly shorter as they are less traumatized and less volume of blood is lost. Hospital stay is generally shorter than three days. Complication rare and mortality rate are very significantly lower relative to the conventional technique.

PORT ACCESS VALVE REPLACEMENT SURGERY

(VALVE REPLACEMENT THROUGH VESSELS IN ARMPIT)

LESS INCISONS, FASTER RETURN TO SOCIAL LIFE

In this modality, cardiac surgeries are carried out through a small incision – intercostal approach, with no need to divide bone or muscle or open the breastbone (sternum).

- Mitral valve replacement or repair

- Aortic valve repair or replacement

- Tricuspid valve repair or replacement

- Double valve repair or replacement

- Triple valve repair or replacement

- Right coronary artery bypass

- Atrial septal defect (ASD)

- PFO repair

- Ventricular septal defect repair

- Myxoma and Fibroblastoma (removal of intracardiac tumors)

Who are eligible for underarm surgeries?

Irrespective of young or old, obese or lean or female or male patient, it can be performed for any patient who has a heart valve problem or requires repair of a cardiac hole.

Who are eligible for underarm surgeries?

Heart valve is exposed with intercostal approach, after a skin incision, measuring 6 to 8 cm, is made parallel to the breast line in the right armpit. In many cases, size of incision can be further shortened using endoscopic imaging methods and tools. Surgery can be performed in an easier, more comfortable and safer manner with video-assisted endoscopic surgery method.

What PROs of the armpit cardiac surgery?

• Postoperative recovery is faster.

• Stay in the ICU and hospital shortens.

• Postoperative need to blood transfusion decreases.

• Postoperative pain is milder and patient can lie down in bed in any position.

• Not being obliged to lie down in supine position for a long time particularly for patients, who are obese or has sleep apnea or who cannot lie down or sleep in supine position, is a great comfort.

• Patient may get out or get in the bed independently or without requiring any help, and may cough easily.

• This technique is free of risk of sternal dehiscence (separation of breastbone), which is a serious risk for osteo­porotic and obese patients, since sterna bone is not divided.

• Postoperative surgical wound healing is quicker.

• Patient is discharged early.

• Patient may resume daily routines easily and quickly right after the surgery.

• Better cosmetic outcomes are achieved. It is particularly preferred by young and female patients, since its es­thetic quality is higher.

CARDIOLOGY

Medistate Hospital’s Department of Cardiology serves patients by professional physicians who utilize all benefits of contemporarily equipped infrastructure.

In the Department of Cardiology, following conditions are diagnosed and managed; heart attack, heart failure, coro­nary failure, heart and rhythm disorders, cardiac valve diseases, peripheral vascular diseases, aortic disorders, hypertension, hypercholesterolemia and congenital heart diseases.

Diagnostic Procedures available in the Clinic

Electrocardiogram (ECG)

Rhythm Holter (ECG Monitoring)

Color Doppler Echocardiography (ECHO)

Blood Pressure Holter (Ambulatory Blood Pressure Monitoring)

Exercise ECG (Cardiovascular Stress Test, Stress Electrocardiogram)

Cardiac Catheterization and Angiography

Therapeutic Procedures Performed in the Clinic

Percutaneous Coronary Angioplasty, Coronary Stent Implantation, Fractional Flow Reserve (FFR)

Treatment of Peripheral Artery Diseases (Percutaneous Peripheral Angioplasty, Stent Implantation)

Carotid Artery, Angioplasty & Stent Implantation

Mitral Stenosis and Balloon Valvuloplasty

Pacemaker implantation

Arrhythmia (Radiofrequency Ablation)

Percutaneous Management of Adult Congenital Heart Diseases