Department of Cardiac Surgery

Head of Department: Ivo Skalský, MD, PhD, MBA

Activities of the Department:

Comprehensive surgical treatment of heart and intrathoracic major blood vessels
Follow-up of selected groups of patients in outpatient unit before and after cardiac surgery

Organizational units of the Department

2 classic cardiac surgery operating rooms are available for 5 working days a week. Moreover, surgeries are performed at the hybrid and robot-assisted operating rooms, one day a week at each of them. One operating room is opened for 24/7 for urgent procedures.

Changes / new events in the previous year

A total of 790 cardiac surgery procedures were performed in 2016. A lower number of procedures than the planned related to a bed capacity limitation due to a lack of general nursing staff, especially of nurses.
A success of the previous year is full deployment of robot-assisted surgery in the spectrum of cardiac surgery interventions. A total of 40 interventions were carried out, including valve reconstructions, atrial septal defect closures, sampling of arterial grafts for myocardial revascularisation, as well as arrhythmology interventions.
In 2017, a high number of valve interventions continued as compared to coronary vein revascularisations. Their share in the total number of surgeries reached 61.6%. They include both isolated procedures on a single valve, and combined with other valves or other interventions.
We have noted an increase in combined interventions, whose number reached almost 40% of all procedures.
A fifth of surgeries related to acute and emergency interventions which are necessary for a patient on one hand, but on the other, more risky in general, financially highly demanding and have a direct impact on total surgery results.
The total annual mortality of 2.53% is considerably lower compared to a predicted mortality calculated according to Euroscore II, an international scoring system, which is 6.17%. Acute interventions contributed to the total mortality by two thirds.
In the field of valve surgeries, there is still a trend of performing a reconstructive surgery, rather than valve replacement. A share of reconstructive surgeries, especially of mitral valves, reached about 70%. thanks to these results, we have been a leading cardiac surgery centre in the Czech Republic for a long time. In this regard, we can emphasise that approximately 2/3 of mono-procedures on mitral valve were performed using a minimally invasive approach.
Of the spectrum of interventions performed last year, surgeries of congenital heart defects should be mentioned again, as they represented approximately 10% of all procedures last year. This specific programme with excellent results which as been systematically run and developed at our Department in cooperation with the Children Cardiac Centre of the Teaching Hospital in Motol, is not unique only in our country, but also in Europe.
In the scientific area, we cannot omit the involvement of our Department in several clinical studies performed in cooperation with international institutions. The previously reached promising results mean a great perspective especially for our patients.
We continue in cooperation with associated workplaces for whose patients we offer a top cardiac surgery background both for elective, and acute interventions. In particular, they include hospitals in Karlovy Vary, Liberec, Příbram and Kladno.
Intra-hospital interdisciplinary cooperation, especially with the Departments of Cardiology and Vascular Surgery, has continues to our high satisfaction and we believe this trend will be kept in future as well.

Perspectives for development in the next year

In 2018 we plan to perform 800 surgeries. We presume the range of procedures will be similar as in the previous year.
We will further develop three systematic programmes which form our foundation stones. They are: the treatment programme for aortic diseases (we will cooperate with vascular surgery and radiology), the programme for surgical treatment of valve disorders and the programme for congenital heart defects treatment in adulthood (we will further cooperate with the Children Cardiac Centre of the Teaching Hospital in Motol).
In the field of minimally invasive procedures, we would like to remain a leading centre in the Czech Republic.
The implementation and development of robot-assisted surgery is beneficial especially to our patients. Reducing the invasive character of interventions shortens duration of a stay in hospital and increases patient’s comfort, which consequently means improvement in the quality of provided care.