Heart Valve Center of Excellence

For a number of reasons, cardiac valvulopathies constitute a new epidemic in heart diseases. First of all, we live longer, with a mean life expectancy of 80 years. The end of World War II brought a baby boom during the 50s and 60s. These people are now over the age of 60 and recent statistics show that Greece in particular has the 4th most aging population in the world. Consequently, there is a significant number of very elderly people suffering from severe valvulopathy (usually Aortic Valve Stenosis), and the performance of a simple and painless heart triplex in most cardiology offices offers early and reliable diagnosis.

In addition, a heart triplex provides dependable diagnosis of Mitral Regurgitation in relatively young patients (Mitral Myxomatous Degeneration), as they can benefit the most out of a surgical mitral valve repair procedure (valvuloplasty) instead of a valve replacement, and avoid lifelong anticoagulant medication (Sintrom). Thus, the patient can avoid post-operative regular blood tests required by Sintrom as well as the risk for strokes and hemorrhages. Mitral Valvuloplasty is particularly chosen by young women because they can have a normal pregnancy and avoid medications harmful to their fetus (Sintrom has teratogenic effects during the first trimester of pregnancy).

Concluding, the modern management of Aortic Valve Insufficiency in Aortic Root Aneurysms (Marfans syndrome) with the David reimplantation technique, the cornerstone of which is to preserve the aortic valve instead of replacing it, is an internationally established and ideal treatment option for young aortic valve insufficiency sufferers.

Based on the above data, and aiming at the most reliable management of this group of patients, Metropolitan General has founded the first Heart Valve Center of Excellence in Greece, which accommodates all required modern equipment and infrastructure to effectively treat even the most complex cardiac surgery cases.

Specifically, Metropolitan General accommodates:

Operating Rooms with the most specialized equipment for cardiac surgery cases
Polyvalent Intensive Care Unit (ICU)
A dedicated floor staffed by experienced nursing personnel for cardiac surgery inpatients, equipped with cutting-edge medical equipment, and especially a technologically advanced telemetry system to monitor patients and deliver 24/7 timely diagnosis and treatment to any arrhythmias occurring
Cardiac and Medical Imaging Laboratory, both fitted out with modern diagnostic-imaging equipment
Hemodynamics Laboratory on a 24-hour basis
24/7 coverage by on-duty cardiologists and intensivists

Cardiac surgery procedures

The fundamental principle and objective of the Heart Valve Center of Excellence, i.e. “To repair (Valvuloplasty) and preserve the patient’s heart valve instead of replacing it”, constitutes the most modern therapeutic management of valvulopathy in specialized centers abroad.

The Center focuses on the following procedures:

Insufficient mitral valve repair (Valvuloplasty)
Aortic Valve Valvuloplasty due to valvular insufficiency and Marfan’s syndrome (Aortic Root aneurysm)
Tricuspid Valvuloplasty
Valve replacement due to calcification (calcification-valve stenosis)
Ascending aorta aneurysm replacement, as it commonly co-exists with aortic valve diseases (e.g. bicuspid aortic valve)
Surgical treatment of Cardiac Tumors (Myxomas) and Intraventricular Communications (“hole in the heart”)

Surgical results

Cardiac valvulopathy surgical procedures were among the first heart surgeries, with over 50 year of experience and hundreds of thousands of cases. Of course, techniques have advanced and significantly improved over time, and the recorded surgical results are excellent, according to the cardiac surgery statistics of the State of New York and
U.S.A for the last decade (2005-2015).

Overall, the surgical risk of a cardiac valvulopathy is still higher compared to routine Bypass surgeries, and thus, the need for its performance in a specialized Center of Reference is even indeed imperative.

An indispensable condition for the successful outcomes of these surgeries is the due diligence applied in ALL stages of the procedure:

Preoperatively: thorough preoperative evaluation, a week prior to the surgery, and assessment by pneumonology, anesthesiology and physiotherapy consultants. Scheduling for plateletapheresis and blood units.

Intraoperatively: assessment of the valvulopathy status at the beginning of the surgery with the transesophageal echocardiography (ETE), and again at the end of the surgery to establish the successful results of valvuloplasty (sealing of the valve) or assess the proper function of the prosthetic valve, should a replacement has taken place.

Immediate extubation (awakening) of the patient after the surgery to prevent respiratory tract infections which are dangerous especially in the very elderly.

Cardiac Surgery Intensive Care Unit (CICU): the patient stays in the CICU the first night for close monitoring. The majority of the patients are urged to move the next morning, they are transferred to their room at noon, and make their first steps in the evening, assisted by the physiotherapists, i.e. within 24 hours after the surgery in order to avoid any respiratory infections.

Postoperatively: Immediately (on the same evening) and after discharge from CICU, the patient makes his/her first steps with the assistance of physiotherapists. The next day, he/she walks down the corridor and then performs a staircase workout. The immediate mobilization of patients is imperative to prevent any respiratory tract diseases which may be really harmful.

The Medical Team staffing Metropolitan General’s Heart Valve Center of Excellence already holds decades of experience, both in Greece and abroad, and its surgical results are excellent and comparable to Centers of Reference abroad, as it is clearly documented by the cardiac surgery statistics of the State of New York for the period 1992 - 2004.

Staff

Chief: Maria Aroni, MD, FACS, FACC, FCCP, Thoracic surgeon

Associate: Filippos Konstantinidis, ΜD, PhD, Thoracic surgeon

Cardiac anesthesiologists: Konstantinos Patris, Christos Apostolidis

Perfusionists: Karin Schaefer, Vasilis Markou

Contact number: +30 210 6502140 & 121, +30 210 6502000