Cardiac Surgery

UNIT NAME: CARDIAC SURGERY

HEADQUARTERS: Head office and medical offices at Gallucci Center, ground floor; Postoperative Intensive Care Unti at Gallucci Center, ground floor; Ward Unit, Semi-intensive care unit, Transplant Unit, Operative Rooms at Gallucci Center, first floor

DIRECTOR Gino Gerosa, MD

ADMINISTRATIVE OFFICES

Direction: Lara Salviato, 0498212410, lara.salviato@unipd.it

Didactic: Lara salviato, 049 8212410, lara.salviato@unipd.it

Welfare:

 

CARE ACTIVITIES

Types of care activities: a complete assistance of the cardiac surgery adult patient is carried out in the Cardiac Surgery Unit.

Ordinarily in Cardiac Surgery Unit these cardiac surgery operations are accomplished:

  • Coronary artery bypass grafting with or without cardiopulmonary support and also in minimally invasive approaches, when it is possible. According to surgical indications, both arterial and venous conduits are used, for example left and right mammary arteries, radial arteries, and saphenous veins
  • Valvular replacement, with a wide portfolio of biological, mechanical and transcatheter valve substitutes. According to surgical indications, eighter conventional surgery with full sternotomy, or minimally invasive surgery, both ministernotomy and minithoracotomy, or transcatheter approaches are accomplished
  • Valvular repair, in particular for aortic root pathology and mitral valve insufficiency. Furthermore, for the repair of mitral valve regurgitation, according to surgical indications, eighter conventional surgery with cardiopulmonary support or through an off-pump minimally invasive approach neochordae implantation can be accomplished
  • Arrhythmias surgery, with the use of minimally invasive thoracoscopic techniques, too
  • Thoracic aortic aneurysm repair
  • Advanced heart failure treatment though conventional surgery techniques as valvular repair or ventriculoplasty, heart transplant, and combined transplantation in collaboration with others Units, and mechanical circulatory support or total artificial heart implantation

Main technologies/surgical approaches:

  • Coronary artery bypass grafting, with or without cardiopulmonary support, minimally invasive approaches
  • Valvular repair surgery (conventional and minimally invasive techniques)
  • Valvular replacement surgery (conventional/minimally invasive/transcatheter techniques)
  • Aortic root surgery, both replacement and repair surgery (valve sparing technique)
  • Conventional surgery and heart transplantation for end-stage heart failure treatment
  • Mechanical circulatory support (both short- and long-term, both conventional and minimally invasive approaches)
  • Grow-up congenital heart pathologies surgical treatment, both conventional surgery and minimally invasive strategy, and also evaluation for transplant and mechanical circulatory support. This branch is in collaboration with the Pediatric Cardiac Surgery Unit

 

Certificazione di qualità Italiana e/o estera:

  • 1985: First heart transplantation in Italy
  • 2002: First stem cells transplantation in a patient with postischemic dilated cardiomyopathy in Italy
  • 2003: First intracorporeal left ventricular assist device implantation (Berlin Heart Incor) in Italy
  • 2004: First beating-heart coronary artery bypass grafting operation with Da Vinci robotic system in Italy (Ital Heart J 2004;4: 475-8)
  • 2004: First pulmonary veins ablation intervention for paroxysmal atrial fibrillation with Da Vinci robotic system in Italy (Eur J Cardio-Thorac Surg 2004;26:450-2)
  • 2006: First heart transplantation of AB0 incompatibility heart in a newborn in Italy (J Cardiovasc Med 2008;9:854-857)
  • 2007: First implantation of a total artificial heart (SynCardia) in Italy
  • 2011: First successful heart transplant of the patient with the longest survival with a total artificial heart (1374 days) in the world (Eur J Cardiothorac Surg 2016;49:e88-9)
  • 2013: First Jarvik 2000 left ventricular assist device implantation through minimally invasive approach in the world (Ann Thorac Surg 2013;96:712-4)
  • 2015: First off-pump beating-heart combined operation of aortic valve replacement and mitral valve repair in the world (Circulation 2015;131:e430-e434)
  • 2015: First SynCardia 50cc total artificial heart implantation in a heart transplanted patient in the world
  • 2016: First off-pump beating heart complete mitral ring implantation in the world (JACC Cardiovasc Interv 2016;9:e211-213)
  • 2019: First thorax-sparing off-pump beating-heart approach for thrombotic mass removal in the right atrium in a patient undergoing kidney cancer operation in the world (Ann Thorac Surg In PRESS)
  • 2019: First thorax-sparing off-pump beating-heart operation for thrombi removal in the left ventricle (Ann Thorac Surg 2020;110:e445-e447)
  • 2020: First off-pump beating-heart edge-to-edge mitral valve repair through a transapical approach

 

RESEARCH FIELDS

  • Clinical results of aortic valve replacement technologies
  • Clinical results of new technologies on surgical and transcatheter treatment of mitral valve pathology
  • Clinical outcomes of surgical treatment of end-stage heart failure: heart transplant and mechanical circulatory support
  • Physiopathology impact of mechanical circulatory support (long- and short- term devices)
  • Clinical outcomes of new microinvasive technology application in cardiovascular mass removal
  • Clinical results of new technology application in arrhythmias treatment
  • Total bioengineered heart development
  • Development of new bioengineered substitutes for cardiovascular applications (heart valve, vascular graft, other tissues)
  • Development and in vivo proof of concept of a bioengineered platform to treat cardiac rhythm disorders
  • Cardiac and multiorgan reconditioning platform
  • Epigenetic cardiac age evaluation
  • Validation of a bioenginnered animal as immunological human surrogate model

 

Methods:

  • Development, compilation and coordination of clinical registries, both single- and multi-center registry
  • Metanalysis
  • Application of the most advanced laboratory techniques on tissue decellularization, functionalization, tissue typing, imaging, 3D printing, cells repopulation.

 

Principal national and international collaborations:

  • CORIS Veneto
  • Multicenter national registry on rapid-deployment aortic valves: the INTU-ITA registry, coordinating center
  • Multicenter national registry of AngioVac system, coordinating center
  • Multicenter national registry on long-term mechanical circulatory support: the ITAMACS registry, participating center

 

TEACHING ACTIVITIES

Cardiac Surgery Residence School

 

TEACHING SPACES

  • Aula di Cardiochirurgia, ground floor Gallucci Center
  • Biblioteca di Cardiochirurgia, ground floor Gallucci Center
  • Centro di Elaborazione Dati, ground floor Gallucci Center

 

LABORATORIES

  • L.I.F.E.L.A.B. , northern 5° floor nord,  Istituto di Ricerca Pediatrica, Lab Manager Todeschini Giulia, tel. 049 8218858
  • Laboratory of vardiovascular regenerative medicine, Prof. Gino Gerosa, Campus Biomedico, tel 049 8217651

 

Teacher