After a slow start, fighting against resistant attitudes, the last decades of the 20th century have shown significant progress in the field of the cardiac and cardiovascular surgery, which are now considered to be modern surgical specialties.
Cardiac surgery is a truly demanding profession which must be practiced by highly trained individuals, as part of an organized team, in a specialized environment, to help minimize the risk of high mortality and poor surgical results.
In addition, this very complicated process requires sophisticated and costly material resources. This expenditure involves the use of various devices and tools (valvular prostheses, heart-lung machine circuits, etc) and this means that nowadays cardiac surgery is very expensive for people who live in countries with limited resources, without assisted health coverage.
This is the main reason why patients with symptoms wait, sometimes too long, before visiting a hospital to be assessed. Unfortunately, this typically means that their heart disease has progressed to being at an advanced stage, and this would require a large financial effort to fix, and this financial burden is often covered by the whole family.
Some patients, without the means to cover an expensive surgery, are instead forced to be treated with inappropriate medical therapy, which will never fix the problem, waiting for the natural evolution of their heart disease.
The Jilin Heart Hospital represents a new vision of treating these patients with heart disease in the North-East of China. Patients with limited resources, who have heart disease, can be included into the Jixin Charity Program, which guarantees the best cardiac treatments for free, through the Chinese government's insurance system.
There are various different types of heart diseases in adult and pediatric cardiac surgery. In our worldwide population the most common involves disease around one of the heart valves (mitral, aortic, tricuspid and pulmonary valves). In these cases, the diseased valves must be repaired or replaced by a prosthesis, to avoid the natural evolution of the disease, towards heart failure and then death.
Cardiac Surgery also involves other types of interventions, concerning the coronary arteries that constantly fuel the heart with oxygen and nutrients. When these vessels are diseased and stenotic (partially-blocked), the heart muscle is poorly supplied by oxygenated blood, so the patient feels chest pain and has a high risk of myocardial infarction (a heart attack) and sudden death.
At our hospital, patient cases with coronary arteries disease, we would normally perform an angiography, to localize the stenotic lesions in the vessels. This treatment depends on the number and severity of the coronary lesions, the location of the obstruction, and the clinical condition of the patient.
Depending on the result of the angiography, these patients can sometimes be treated immediately by percutaneous transluminal coronary angioplasty (PTCA), during the angiography. If this isn’t possible, then the patient is referred to the cardiac surgeons for coronary bypasses, and this usually happens when there are multiple lesions and/or it is too complex. Other types of intervention include the aorta and sometimes the pericardium.
Cardiac surgery is intended to treat patients with heart disease:
· Coronary artery diseases (including acute myocardial infarction)
· Pathologies of the ascending and thoracic aorta (especially aneurysm of the ascending aorta). This service is distinguished by the management of aortic dissections that allowed the development of thoracic aorta surgery.
· Pathologies of the pericardium
At the Jilin Heart Hospital our patients are cared for by foreign cardiac surgeons and cardiologists, who work in collaboration with Chinese doctors. This highly specialized team regularly examines the therapeutic indications of our patients at a weekly multidisciplinary discussion meeting.
The main operations performed by the Cardiac Surgery Department in our hospital include:
· Coronary artery bypass (on-pump or beating-heart). We specialize in coronary surgery with a dedication towards arterial revascularization. Our team has developed a wealth of experience in off-pump beating heart bypasses, sometimes through a small left thoracotomy (mini-CABG technique).
· Surgery of the aortic, mitral and tricuspid valves (that’s repair and/or replacement), including mini-invasive mitral and aortic surgical treatment
· Surgery of the ascending and thoracic aorta. All these operations, which are commonly practiced here, start from very conservative surgery of the aortic root, and go up to the most complex surgeries regarding the aortic arch
· Correction of congenital heart disease in adults and children