Cardiac surgery, with its present techniques, is a recently developed specialty in surgery. The apparatus that made it possible is extracorporeal circulation, developed only 50 years ago. This technology allows surgeons to replace the vital functions of both the heart and the lungs by a pump that pushes oxygenated blood through all the organs of the body and aspirates venous blood to an artificial oxygenator where gas exchanges are made. This temporary support gives the surgeon time to repair diseases on the surface and the inside of the heart, while the heart is stopped and rested. Valves, which guide blood in the right direction, may be repaired or replaced by artificial valves. Coronary arteries that feed the heart muscle and may become obstructed, can be repaired by bypasses using veins from the legs or arteries from the chest wall. Congenital abnormalities (in born errors in the construction of the heart) may also be repaired, as well as other less frequent diseases. Finally, in recent years, heart transplantation as well as impla ntation of long-term artificial pumps that assist or replace the heart have also become part of the general therapeutic options.
In the course of the development of heart surgery over the last fifty years, marked progress has been made in maximising both safety and efficacy. Nowadays, most operations on the heart can be performed with minimal risk even in elderly patients with severe disease. There are major efforts made at present to 1) simplify procedures when appropriate, for example by avoiding the use of extra-corporeal circulation (so-called "off-pum p" and "mini mally invasive" operations); 2) reduce the size of incisions (thus decreasing post-operative discomfort and length of hospital stay); 3) repair natural structures whenever possible rather than replace them by an artificial device (mitral valve repair for example).
Cardiac surgery has been an important specialty at La Tour for nearly thirty years. Patients from Geneva and other parts of Switzerland, as well as numerous patients from Germany, North Africa and the Balkans have been operated for all forms of heart diseases (excepting transplantation). Many of these patients were on waiting lists in their countries, and after being transferred to Geneva, could be rapidly operated upon by the team of surgeons and anesthesiologists at La Tour, using modern equipment and aided by an experienced intensive care staff. The recently reconstructed ten-bed intensive care unit and operating theatre are an excellent environment for such procedures. A typical hospital stay for cardiac surgery usually lasts 5-10 days. This com prises a 24-48h preopera tive period for a com prehensive check-up, a 24-48h stay in the intensive care unit immediately after the operation, and a 3-7 days early recovery phase in a normal ward.
The experience gained in Geneva has been transmitted to other countries, wishing to develop or perfect their own cardiac surgery program, but requiring guidance to do so. Several teams from La Tour have thus spent many weeks abroad teaching, operating, training local staff and transferring know-how in Turkey, Bosnia, Macedonia, Algeria and Georgia. These efforts are very much in the Swiss, and more particularly genevese, tradition of interventions with a humanitarian goal. Most of these actions were supported and sponsored by two charita ble foundations, the Medaid Foundation and the Frederic and Jean Maurice Foundation, created by members of the staff of La Tour.
Last modified on December 15th, 2015.
Unless specified otherwise, this text has been written by the editorial team.
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