Department: CARDIOVASCULAR SURGERY

SERVICII MEDICALE

Spectrul patologiilor tratate in clinica de chirurgie cardiovasculara a Spitalului Universitar de Urgenta Bucuresti include toate patologiile cardiovasculare capatate ale adultului si patologiile cardiace congenitale la adult, dar si toate patologiile vasculare periferice.

Prezervarea valvulara, repararea tesutului propriu al organismului prin tehnicile de plastie valvulara, ofera rezultate semnificativ mai bune pentru pacienti atat pe termen mediu cat si lung. Din acest motiv in clinica noastra, plastiile valvulare reprezinta prima alegere in tratarea chirurgicala a bolilor valvelor cardiace. Cu ajutorul tehnicilor endoscopice si minim-invazive pot fi tratate, acolo unde este cazul, boli ale valvelor cardiace sau ale arterelor coronare prin incizii semnificativ mai mici si evitand deschiderea sternului.

Serviciul de Chirurgie Cardiovasculara din cadrul Spitalului Universitar de Urgenta București este primul si pana in acest moment singurul centru din Romania in care sunt practicate începând cu 2018 operatii complet endoscopice pentru tratamentul patologiilor valvulare aortice, mitrale, tricuspide, dar și pentru corectarea defectelor septale.

Colaborarea cu medicii din alte specialități ale Spitalului Universitar de Urgență București, în special în cadrul comisiilor „Heart-Team” (Echipa Inimii) și „Endocarditis Team”, alături de colegii din domeniile Cardiologie, Cardiologie Intervențională, Boli Infecțioase, Neurologie, Radiologie și Anestezie Terapie Intensivă Cardiovasculară, consolidează capacitatea noastră de a oferi pacienților tratamente optime pentru a depăși afecțiunile cardiace cu care se confruntă.

In cadrul Sectiei Clinice de Chirurgie Cardiovasculara activeaza si Compartimentul de Chirurgie Vasculara periferica. Spectrul patologiilor tratate in compartimentul de chirurgie vasculara a Spitalului Universitar de Urgenta Bucuresti include tratamentul bolii arteriale periferice, anevrisme arteriale, incluzand aici si anevrismele aortei, traumatisme vasculare, complicatii vasculare dar si crearea unor cai de angioacces pentru pacientii cu necesar de hemodializa sau crearea unui abord vascular destinat administrarii de chimioterapice.

LISTĂ MEDICI

SPECTRUL CHIRURGICAL PRINCIPAL INCLUDE

• Reconstructia radacinii aortice prin prezervare valvulara aortica (Tehniciile: Tirone David, Yacoub in functie de patologie)
• Plastia sau protezarea de valva aortica (prin abord minim-invaziv sau endoscopic)
• Plastia sau protezarea de valva mitrala (prin abord minim-invaziv sau endoscopic)
• Plastia de valve tricuspida (inclusiv tratamentul bolii Ebstein, prin abord minim-invaziv sau endoscopic)
• Cura anevrismului de aorta ascendenta cu inlocuire valvulara (Bentall modificat)
• Cura anevrismului de aorta ascendenta cu pastrarea valvei native (Tirone David)
• Revascularizarea coronariana complet arteriala cu circulatie extracoporeala sau pe cord batand (OPCAB)
• Cura chirurgicala a tumorilor cardiace (inclusiv minim-invaziv unde este cazul)
• Cura chirurgicala a tumorilor cardiace maligne cu reconstructia structurilor cardiace afectate
• Cura chirurgicala a cardiopatiilor congenitale la adulti (GUCH)
• Cura anevrismului de crosa aortica
• Tratamentul transcateter al anevrismelor de crosa aortica, aorta descendenta toracica si abdominala – TEVAR/EVAR
• Tratamentul patologiilor valvulare combinate
• Tratamentul cardiomiopatiei hipertrofice obstructive
• Tratamentul tumorilor cardiace si vasculare
• Tratamentul defectelor septale la adult
• Patologii cardiace congenitale la adult
• Tratamentul urgentelor cardiace
• Chirurgia arterelor carotide
• Chirurgia aortei si a vaselor periferice

 

SPECTRUL CHIRURGICAL ÎN CADRUL COMPARTIMENTULUI DE CHIRURGIE VASCULARĂ INCLUDE:

• Tratamentul pacientilor este atat chirurgical cat si endovascular.
• Tehnici chirurgicale de tipul revascularizariilor prin bypass si endarterectomii, angioplastii, tehnici endovasculare prin PTC cu implantare de stent si dilatare cu balon, pentru ocluzii si stenoze arteriale.
• Tehnici chirurgicale de tip cura anevrismelor vasculare prin rezectie anevrism si bypass, tehnici endovasculare prin implantarea de endoproteze vasculare, pentru anevrisme de aorta abdominala si de artere periferice.
• Tratament chirurgical in boala varicoasa cronica.
• Abord chirurgical pentru pacientii cu hemodializa –fistule arteriovenoase, montare CVC LL.
• Abord vascular pentru pacientii cu necesar de chimioterapie CVC port a cath

DOTARE

Bloc operator de Chirurgie Cardiovasculara dotat conform cu standardul european (2020) dispune de doua sali de interventii chirurgicale majore si o sala destinata interventilor minore. Fiecare sală dispune de:

• Flux laminar cu posibilitate de reglare si monitorizare a temperaturii
• Pompa de circulatie extracorporeala Stoeckert S5
• Aparat de anestezie pentru proceduri complexe
• Aparatura de monitorizare a functiilor vitale si a parametrilor de evaluare hemodinamica
• Ecocardiograf cu sonda transesofagiana 2D si 3D – General Electric Vivid E95
• Turn Aesculap Einstein 3D pentru proceduri chirurgicale endoscopice
• Aparatura de monitorizare a perfuziei cerebrale (NIRS)
• Defibrilator cu padele interne si padele atasate pentru interventiile minim-invazive
• Stimulatoare bicamerale externe pentru controlul ritmului cardiac perioperator
• Aparat de masurare flux sangvin intraoperator (Flowmetru)
• Lampa scialitica
• Sistem focalizat de iluminare
• Masa chirurgicala radiotransparenta cu specific de chirurgie cardiovasculara
• Aparat determinare coagulare (ACT) si aparat de trombelastografie
• Saltele cu sistem de racire/incalzire
• Sistem de autotransfuzie (Cell Saver)
• Consola pentru balon de contrapulsatie intraaortic
• Aparate de electrocoagulare monopolarã şi bipolară
• Aparate portabile de aspiraţie
• Echipament si instrumentar pentru intervenţii minim-invazive si endoscopice
• Instrumentar chirurgical pentru operatii conventionale
• Sala hibrida
• C-ARM mobil

 

SECTIA CLINICĂ DE CHIRURGIE CARDIOVASCULARĂ DISPUNE DE:

• Sala pentru interventii hibride dotata conform cu standardul european 2016 (Heart Team)
• Cabinet de evaluare ecocardiografica si doppler vascular pre- si postoperator
• Cabinete de consultatii
• Sala de pansamente
• Saloane de urmărire postoperatorie (monitorizare EKG) cu unul, doua sau trei paturi, cu grup sanitar propriu
• Colaborare directa cu sectia de anestezie si terapie intensiva cu paturi si personal dedicat in exclusivitate cazurilor de chirurgie cardiovasculara
• Colaborare cu cele doua clinici de cardiologie si cardiologie interventionala ale spitalului

 

DOMENII DE CERCETARE

• Reconstructiile valvulare in endocarditele acute
• Reconstructiile radacinii aortice cu prezervarea sau plastia valvulara aortica
• Cardiopatii coronariene in insuficienta ventriculara stanga – tratamentul prin tehnici hibride
• Tratamentul endovascular al anevrismelor/disectiilor de aorta descendenta toracica si abdominala, planning preoperator bazat pe tehnici de reconstructie 3D ghidate de softuri
• bazate pe inteligenta artificiala
• Evaluare preoperatorie a pacientilor cu patologii cardiovasculare cu ajutorul tehnicilor de printare 3D
• Tratamentul tumorilor cardiace
• Tehnici si optiune de explantare valvelor implantate interventional

 

ARTICOLE PUBLICATE LA NIVEL INTERNATIONAL DE CATRE MEDICI AI CLINICII NOASTRE (ISI Thompson/PubMed):

• Catalin C. Badiu*, Rüdiger Lange*, Manfred Vogt, Bernhard Voss, Jürgen Hörer, Zsolt Prodan, Christian Schreiber, Domenico Mazzitelli
  Valve-sparing root replacement in children with aortic root aneurysm: mid-term results
  Eur J Cardiothorac Surg. 2013 May;43(5):958-64.
  * Both authors contributed equally

 

• Catalin Constantin Badiu , Constantinos Sideris, Marcus André Deutsch, Markus Krane, Ina Hettich, Bernhard Voss, Domenico Mazzitelli, Rüdiger Lange
  Aortic root replacement: Comparison of clinical outcome between different surgical techniques
  Eur J Cardiothorac Surg. 2014 Oct;46(4):685-92; discussion 692

 

• Catalin C. Badiu, Bernhard Voss, Magdalena Dorfmeister, Rüdiger Lange
  Valve-sparing root replacement: Where are the limits?
  Tex Heart Inst J 2011;38(6):661-2)

 

• Catalin C. Badiu, Sabine Bleiziffer, Walter B. Eichinger, Iva Zaimova, Andrea Hutter, Domenico Mazzitelli, Bernhard Voss, Rüdiger Lange
  Are bicuspid aortic valves a limitation for aortic valve repair?
  Eur J Cardiothorac Surg. 2011 Nov;40(5):1097-104.

 

• Catalin Constantin Badiu, Sabine Bleiziffer, Anke Opitz, Ina Hettich, Marcus-Andre Deutsch, Markus Krane, Bernhard Voss, Rüdiger Lange
  Hemodynamic performance of the Biovalsalva Valved Conduit after Aortic Root Replacement
  J Heart Valve Dis. 2014 Jan;23(1):97-104

 

• Catalin C. Badiu, Sabine Bleiziffer, Walter B. Eichinger, Ina Hettich, Markus Krane, Robert Bauernschmitt, Rüdiger Lange
  Long-term performance of the Hancock bioprosthetic valved conduit in aortic root position
  J Heart Valve Dis, 2011. 20(2): p.191-98.

 

• Badiu CC, Eichinger W, Bleiziffer S, Hermes G, Hettich I, Krane M, Bauernschmitt R, Lange R.
  Should root replacement with aortic valve-sparing be offered to patients with bicuspid valves or severe aortic regurgitation?
  Eur J Cardiothorac Surg. 2010 Nov;38(5):515-22. Epub 2010 Apr 18.

 

• Badiu CC, Schreiber C, Hörer J, Ruzicka DJ, Wottke M, Cleuziou J, Krane M, Lange R.
  Early timing of surgical intervention in patients with Ebstein’s anomaly predicts superior long-term outcome.
  Eur J Cardiothorac Surg. 2010 Jan;37(1):186-92. Epub 2009 Aug 19.

 

• Badiu CC, Eichinger W, Ruzicka D, Hettich I, Bleiziffer S, Bauernschmitt R, LAnge R
  Long-term performance of the Hancock bioprosthetic conduit for aortic root replacement
  Thoracic and Cardiovascular Surgeon – 01/2008; 56

 

• Badiu CC, Vasilescu A, Danet A, Zimnicaru O, Tudorica S, Blindaru A, Tudor C.
  How to perform a late explantation of a Sapien XT transcatheter aortic prosthesis.
  J Card Surg. 2020 Sep;35(9):2338-2340.

 

• Blindaru A, Vasilescu A, Danet A, Zimnicaru O, Cristu M, Tudorica S, Borjog T, Patrascu O and Badiu CC (2023)
  Surgical resection of a giant cardiac angiosarcoma and reconstruction of involved right heart structures: A case report.
  Front. Cardiovasc. Med. 10:1115962.

 

• Lange R, Burri M, Eschenbach LK, Badiu CC, da Silva JP, Nagdyman N, Fratz S, Hörer J, Kühn A, Schreiber C, Vogt MO.
  Da Silva’s cone repair for Ebstein’s anomaly: effect on right ventricular size and function.
  Eur J Cardiothorac Surg. 2015 Aug;48(2):316-20; discussion 320-1

 

• Deutsch MA, Prinzing A, Fiegl K, Wottke M, Badiu CC, Krane M, Goppel G, Bleiziffer S, Guenzinger R, Lange R.
  Early haemodynamic performance of a latest generation supra-annular aortic bioprosthesis: experience from a large single-centre series.
  Eur J Cardiothorac Surg. 2015 Dec 10. pii: ezv411. [Epub ahead of print]

 

• Krane M, Deutsch MA, Piazza N, Muhtarova T, Elhmidi Y, Mazzitelli D, Voss B, Ruge H, Badiu CC, Kornek M, Bleiziffer S, Lange R.
  One-Year Results of Health-Related Quality-of-Life Among Patients Undergoing Transcatheter Aortic Valve Implantation.
  Am J Cardiol. 2012 Jun 15;109(12):1774-81

 

• Mazzitelli D, Nöbauer C, Rankin JS, Badiu CC, Krane M, Crooke PS, Cohn WE, Opitz A, Schreiber C, Lange R.
  Early results after implantation of a new geometric annuloplasty ring for aortic valve repair.
  Ann Thorac Surg. 2013 Jan;95(1):94-7

 

• 01.Mazzitelli, C. Nöbauer, J. S. Rankin, C. C. Badiu, M. Dorfmeister, P. S.Crooke, A. Wagner, C. Schreiber, R. Lange
  Early Results of a Novel Technique for Ring-Reinforced Aortic Valve and Root Restoration
  Eur J Cardiothorac Surg. 2014, Mar;45(3):426-30

 

• Deutsch MA, Krane M, Schneider L, Wottke M, Kornek M, Elhmidi Y, Badiu CC, Bleiziffer S, Voss B, Lange R
  Health-Related Quality of Life and Functional Outcome in Cardiac Surgical Patients Aged 80 Years and Older: A Prospective Single Center Study
  J Card Surg. 2014 Jan;29 (1):14-21

 

• Elhmidi Y, Gunzinger R, Deutsch MA, Badiu CC, Krane M, Lage R
  Outcomes of Patients Undergoing Third-Time Aortic or Mitral Valve Replacement
  J Card Surg. 2014 Jan; 29 (1):8-13

 

• Krane M, Voss B, Hiebinger A, Deutsch MA, Wottke M, Hapfelmeier A, Badiu CC, Bauernschmitt R, Lange R
  Twenty years of cardiac surgery in patients aged 80 years and older: risks and benefits.
  Ann Thorac Surg. 2011 Feb;91(2):506-13.

 

• Voss B, Bauernschmitt R, Brockmann G, Krane M, Badiu CC, Lange R
  Sternal reconstruction with plates and cables in complicated sternal dehiscence
  Thoracic and Cardiovascular Surgeon – 01/2010; 58

 

• Gozar H, Gozar L, Badiu CC, Suciu H
  Congenital umbilical arterio-venous malformation: A word of caution
  Inter CardioVasc and Thor Surg. 2014 May;18(5):688-9

 

• Krane M, Mazzitelli D, Schreiber U, Garzia AM, Braun S, Voss B, Badiu CC, Brockmann G, Lange R, Bauernschmitt R.
  LIFEBRIDGE B2T–a new portable cardiopulmonary bypass system.
  ASAIO J. 2010 Jan-Feb;56(1):52-6.

 

• Ruzicka DJ, Hettich I, Hutter A, Bleiziffer S, Badiu CC, Bauernschmitt R, Lange R, Eichinger WB.
  The complete supraannular concept: in vivo hemodynamics of bovine and porcine aortic bioprostheses.
  Circulation. 2009 Sep 15;120(11 Suppl):S139-45.

 

• Krane M, Bauernschmitt R, Voss B, Badiu CC, Lange R.
  Right ventricular fibroma in a 61-year-old man.
  Thorac Cardiovasc Surg. 2009 Jun;57(4):235-7. Epub 2009 May 20.

 

• Krane M, Bauernschmitt R, Hiebinger A, Wottke M, Voss B, Badiu CC, Lange R.
  Cardiac reoperation in patients aged 80 years and older.
  Ann Thorac Surg. 2009 May;87(5):1379-85.

 

• Eichinger W, Badiu CC, Hettich I, DJ Ruzicka, Hutter A, Bleiziffer S, Bauernschmitt R, Lange R
  Surgical repair techniques of complex sinus of valsalva aneurysm with perforation or involvment of the coronary ostia
  Thoracic and Cardiovascular Surgeon-01/2009;56

 

• Bleiziffer S, Eichinger WB, Hettich IM, Ruzicka D, Badiu CC, Guenzinger R, Bauernschmitt R, Lange R.
  Hemodynamic characterization of the Sorin Mitroflow pericardial bioprosthesis at rest and exercise.
  J Heart Valve Dis. 2009 Jan;18(1):95-100.

 

• Krane M, Bauernschmitt R, Hiebinger A, Voss B, Badiu CC, Wottke M, Lange R
  No differences in long term survival between primary cardiac surgery and cardiac reoperation in patients aged 80 years and older
  Thoracic and Cardiovascular Surgeon– 01/2009;56

 

• Krane M, Dummler S, Dressen M, Lahm H, Tesche C, Wildhirt S, Voss B, Badiu CC, Lange R, Bauernschmitt R
  Identification of an up-regulated anti-apoptotic gene network in the internal thoracic artery compared to the radial artery
  Atherosclerosis Supplements-01/2009; 10(2)

 

• Eichinger W, Badiu CC, Ruzicka D, Hettich I, Bleiziffer S, BAuernschmitt R, Lange R
  Aortic valve-sparing operations: reimplantation vs. remodeling
  Thoracic and Cardiovascular Surgeon 01/2008; 56

 

• Schreiber C, Heimisch W, Schad H, Brkic A, Badiu C, Lange R, Bauernschmitt R.
  C1-INH and its effect on infarct size and ventricular function in an acute pig model of infarction, cardiopulmonary bypass, and reperfusion.
  Thorac Cardiovasc Surg. 2006 Jun;54(4):227-32.

 

• 01.Enescu, M. Cinteza, D.Vinereanu,
  Early Repolarization Syndrome- to Be or Not to Be Benign,
  Maedica (Buchar). 2011 July; 6(3): 215–219

 

• 01.Florescu, D. Benea, R Rimbas, M Diena, G.Lanzzillo, O.Enescu, M.Cinteza, D.Vinereanu.
  Myocardial systolic velocities and deformation assessed by speckle tracking for early detection of left ventricular dysfunction in asymptomatic patients with severe mitral regurgitation.
  Echocardiography. 2012 Mar;29(3):326-33.

 

• Florescu M; Magda LS; Enescu OA; Jinga D, Vinereanu D.
  Early Detection of Epirubicin-Induced Cardiotoxicity in Patients with Breast Cancer.
  J Am Soc Echocardiogr 2014;27(1):83-92.

 

• Enescu O.
  Antioxidants rich foods may influence chronic obstructive pulmonary disease evolution.
  Maedica (Buchar). 2010 Dec;5(4):308.

 

• Enescu O.
  Is homoarginine level associated with high cardiovascular risk and mortality?
  Maedica (Buchar). 2010 Jul;5(3):227

 

• Margulescu AD, Enescu OA, Vinereanu D.
  A regularly irregular rhythm-what is the diagnosis?
  Neth Heart J. 2016 Feb;24(2):156-8.

 

• Mihalcea DJ, Florescu M, Suran BM, Enescu OA, Mincu RI, Magda S, Patrascu N, Vinereanu D
  Comparison of pulse wave velocity assessed by three different techniques: Arteriograph, Complior, and Echo-tracking.
  Heart Vessels. 2016 Apr;31(4):568-77