Cardiac surgery

For the first time south of Lisbon

by Dr. Angelo Nobre [email protected]

Dr. Angelo Nobre has a vast experience in Cardio-Thoracic Surgery, working in one of the main hospitals in Lisbon, and now also in Hospital Particular do Algarve.

The heart is a muscle the size of a fist that pumps blood continuously throughout the body.  It is made up of four compartments or chambers, two auricles and two ventricles. Each ventricle has one inlet valve and one output valve.

Complications with heart valves in most cases are congenital, caused by rheumatic fever or infection or due to degenerative causes, and can also be age related.

Valve related disease can cause the valve not to open properly, which hinders the passage of blood, known as valvular stenosis, or the valves may not close completely causing blood loss, known as valvular insufficiency.  There may also be a combination of the two, known as double valve damage.

In heart valve surgery, repair of a damaged heart valve may be carried out or a replacement of the valve may be necessary.  The patient’s heart valve is replaced by a prosthesis which may be totally synthetic or of biological materials.

The heart needs a continuous supply of blood in order to maintain its normal function, which is to pump blood. The supply and oxygenation of the heart muscle is done by the coronary arteries.    

There is a left coronary artery that is divided into an anterior descending artery and a circumflex artery as well as a right coronary artery.

The coronary arteries can be affected by atherosclerosis and calcification, which can cause a partial or total obstruction of the lumen of the artery, leading to a reduction of blood flow. This lack of blood flow is the cause of angina pectoris.

When there is a total lack of blood flow or a decreased blood flow for a long period of time, this may cause a partial muscle death in the affected areas, known as myocardial infarction.

The treatment of coronary arteries can be accomplished with drugs or by interventional cardiology, with the placement of stents.  

In severe cases, where medical treatment is not sufficient, cardiac surgery may be the ultimate solution. The implantation of aorta-coronary bypass conduits may be the only permanent solution for the patient.

Cardiac Surgery Unit at Hospital Particular do Algarve in Faro

The Cardiac Surgery Unit is part of the Cardiovascular Department of the Hospital Particular do Algarve. It works in close relationship with the Department of Cardiology and the Hemodynamics Unit, supporting and providing the necessary coverage in surgically invasive treatments by interventional cardiology when performing coronary artery bypass grafts through percutaneous angioplasty.

The Cardiac Surgery Unit is also a support and back-up for the electrophysiology specialists in the treatment of arrhythmias.

The Cardiac Unit of Hospital Particular do Algarve, comprising a team of Cardiothoracic Surgery Specialists who are on call 24 hours a day every day of the year, is able to deal with any cardiovascular emergency that may arise, respecting the necessary “timing” in each individual case.

All the necessary, latest generation cardiovascular surgery equipment is available at Hospital Particular do Algarve where cardiac surgery is now a reality.  

The post-operative care in Cardiac Surgery is equally important and the Intensive Care Unit at Hospital Particular do Algarve in Faro has highly trained medical and nursing staff able to provide the necessary post-operative care essential to cardiac surgery, to solve any complications that may arise in the immediate postoperative period.

The training of staff has taken place as an internship at one of the main hospitals in Lisbon where an average of five open heart surgeries takes place every day.

Cardiac surgery undertaken

Coronary Surgery: performed without extracorporeal circulation in 100% of patients.  Use of artificial grafts whenever possible, including left internal mammary artery and right radial artery. Extraction of venous conduits with minimally invasive techniques.

Mitral Vascular Surgery: Valve repair in 90% of cases of valve disease due to either rheumatic, degenerative or infectious origin.

Aortic Valve Surgery: Valve replacement in 90% of cases by mechanical or biological prosthesis depending on each case. Use of biological materials such as homograft for the treatment of endocarditis.

Aortic Surgery:  Treatment of diseases of the ascending aorta and thoracic aorta such as aneurysms, traumatic ruptures of the aorta or Type A dissections.

It is also possible to carry our urgent pediatric heart surgery as the whole team is trained in pediatric cardiac surgery.

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