Presentation

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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