Cardiac Surgery

Alessandro Frigiola

Years of experience: 41

Head of Pediatric Cardiac Surgery and Congenital Heart Disease in adults - IRCCS Policlinico San Donato

Co-Director of Cardiac Surgery Area and Head of International Cooperation

It is one of the leading experts in cardiac surgery for congenital and acquired heart diseases both for children and adults.
He performed over 10,000 procedures. He is specialized in surgical repair of the mitral valve and the aorta (over 1,000 operations).
He is one of the most experienced Italian and European surgeon for Ross intervention (replacement of aortic valve with the pulmonary valve from the same patient).
For over 25 years, he has been engaged in international cooperation activities for the development of cardiac surgery in 18 countries worldwide.
AATS member (American Association Thoracic Surgery).

It is one of the leading experts in cardiac surgery for congenital and acquired heart diseases both for children and adults.

He performed over 10,000 procedures. He is specialized in surgical repair of the mitral valve and the aorta (over 1,000 operations).

He is one of the most experienced Italian and European surgeon for Ross intervention (replacement of aortic valve with the pulmonary valve from the same patient).

For over 25 years, he has been engaged in international cooperation activities for the development of cardiac surgery in 18 countries worldwide.

AATS member (American Association Thoracic Surgery).

CLINICAL ACTIVITY
The Pediatric Cardiac Surgery Unit is one of the most important European centers for neonatal cardiac surgery.

As far as neonatal and children mitral disease is concerned, Dr Frigiola is the only surgeon in Italy who uses as an alternative to other types of surgery the technique of mitral valve replacement with Melody biological valve.

The Unit is also involved in hybrid cardiac interventions in collaboration with the cardiology team.

Over the years, the Unit has become the most important Italian centre for adult cardiac surgery.

Minimally invasive cardiac surgery is one of the most popular innovations in the world of surgery, because it allows to perform interventions on the heart and its nearby structures while minimizing the stress for the patient.

All interventions performed by Dr Glauber are carried out with a specific 3D column which allows a better perspective view to the surgeon.

Different techniques are used depending on the problem - however, all of them require quicker recovery times less scars and blood loss.

Departments 38 beds, including 18 fully monitored for semi-intensive therapy.

Echocardiography service equipped with the most modern equipment (Three-dimensional echocardiography).

For the preoperative evaluation and postoperative follow-up, there are also a cardiac surgery outpatient clinic as well as clinics dedicated to specific diseases (surgery of heart cardiac oupatient clinic, arrhythmias surgery outpatient clinic, valvulopathies outpatient clinic, percutaneous procedures outpatient clinic: TAVI and MitraClip).

Pediatric and adult cardiac surgery Congenital disorders:

  • Transposition of the great vessels
  • Pulmonary Atresia
  • Truncus
  • Total Anomalous Pulmonary Venous Return
  • Single Ventricle
  • Aortic valve disease.


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Ottavio Alfieri

Years of experience: 30

Head of Cardiac Surgery at the IRCCS Ospedale San Raffaele

Specialist in General Surgery, Thoracic Surgery, and Cardiac Surgery.
Council member of the Italian Society of Cardiac Surgery and member of the American Association for Thoracic Surgery (AATS).
Member of the editorial Board of various Italian and foreign scientific journals, and author of more than 300 publications.
His most significant contributions are in the field of coronary surgery, valve surgery, and in the surgery of cardiac arrhythmias and of heart failure. He has tied his name to a mitral repair technique: “Edge to Edge Alfieri repair”. He owns the patent on a ring mitral prosthesis, designed to correct the mitral ischemic failure.
He has personally performed more than 10.000 major cardiac surgical procedures.

AFFILIATIONS

  • Italian Society of Cardiac Surgery(SICCH)
  • European Association for Cardiothoracic Surgery (EACTS)
  • American Association for Thoracic Surgery (AATS)
  • Society of Thoracic Surgeons (STS).

SURGERY
1.500 surgical procedures each year, covering the widest spectrum of the cardiac surgery discipline. The Unity is national centre of reference for the restorative surgery of the mitral valve (about 500 hundred procedures per year), for the atrial fibrillation surgery, for the heart failure surgery, and for the hypertrophic obstructive cardiomyopathy surgery. The Cardiothoracic-Vascular Department offers the most qualified specialist consultancy.

DEPARTMENT:

  • 38 beds, 18 of which fully monitored for semi-intensive care
  • Support to post-operative Intensive Care (Chief physician Professor A. Zangrillo), with 14 beds equipped with the most sophisticated assistive cardiovascular and respiratory technologies
  • Dedicated service of echocardiography (Chief Physician Doctor Giovanni La Canna), provided with the most modern equipment (three-dimensional echocardiography)
  • For the pre-operative evaluation and the post-operative follow-up of patients, a cardiac surgery divisional ambulatory and ambulatories dedicated to specific pathologies (Heart failure surgery ambulatory, Arrhythmias surgery ambulatory, Valve diseases ambulatory, Percutaneous procedures ambulatory - TAVI and MitraClip)
  • 7.30 a.m. meeting to discuss clinical cases and weekly cardio-team meeting (cardiac surgery - cardiology) to discuss clinical cases and percutaneous treatment procedures.

MAIN DISEASES AND TREATMENTS

  • Valve diseases (restorative and replacement surgery; mini-invasive treatment; percutaneous treatment)
  • Coronary artery disease (surgery with artery bypass, beating-heart surgery, and also treatment with stem cells and bone marrow stimulation in refractory angina)
  • Aortic aneurysms (traditional surgery and endoprosthesis)
  • Atrial fibrillation ablation (isolated or associated with surgical procedures such as valve replacement or myocardial revascularization)
  • Non-transplantation surgery of the heart failure (implant of cardiovascular assistance mechanical systems, such as ECMO, L-VAD, and total artificial heart, left ventricle remodelling techniques, myocardial revascularization techniques, and mitral valve plasty, resynchronization)
  • Treatment of adult congenital heart disease (surgical or percutaneous correction) and of congenital heart disease after neonatal age
  • Hypertrophic obstructive cardiomyopathy (surgical treatment or fortification)

RESEARCH & HIGH TECHNOLOGY
Most of the research programs are “departmental”, within a context of a fruitful multidisciplinary cooperation:

  • Cardiac valves disease
    Today, the developed original surgical technique for the repair of the mitral valve (“Alfieri mitral valve repair” or “Edge-to-edge” technique), is applied worldwide
  • Heart failure
    The heart failure surgery (as an alternative to transplantation) is performed on a large number of patients. Results are evaluated through innovative and sophisticated techniques (pressure-volume curves with conductive catheters), which have allowed a better understanding of the mechanisms of action of the diverse surgical procedures and a refinement of the surgical indications
  • Coronary disease treatment
    Our Department has taken part to the most important prospective randomized studies in the history of coronary disease treatment (SYNTAX, FREEDOM, EXCEL). The results of surgery and of medicated stents in the left main coronary artery disease have been assessed comparatively. The acute effects of beating-heart coronary surgery on ventricular function have been widely studied
  • Arrhythmias surgery
    An original technique of surgical ablation of atrial fibrillation through epicardial unipolar radiofrequency has been developed. This technique has been used on a large number of atrial fibrillation patients who have undergone mitral surgery
  • EVITA Aortic surgery
    The aneurysmal pathology of the thoracic aorta (especially of the bicuspid aortic valve) are studied. Furthermore, the results of ascending aorta replacement are studied, associated with preservation of the native aortic valve
  • Minimally-invasive surgery
    Protagonist of the first robotic surgery in the world. The wide areas of application of minimally-invasive surgery are especially related to cardiac valves and arrhythmias
  • Imaging techniques
    The introduction of new imaging techniques (three-dimensional echocardiography, RMN, multislice CT) has represented an attractive investigation opportunity for cardiac surgery and many study protocols are being currently conducted. Original algorithms for different diseases have been developed

Application of genetics and genomics to the cardiac surgery patient (outcome research).



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Lorenzo Menicanti

Years of experience: 26

Head of Unit – Cardiac surgery - IRCCS Policlinico San Donato

Diploma in Medicine and Surgery, Università Cattolica del Sacro Cuore (1975).
Specialization in Cardiac Surgery, Università degli Studi di Padova.
Member of the Association of Hospital Cardiologists, American Association of Thoracic Surgery, European.
Association of Cardio Thoracic surgery and European Board of Thoracic and Cardiovascular Surgeons.

NUMBERS - year 2014
INTERVENTIONS:
1,600 including:

  • Bypass / Bypass + valve replacement / bypass: 395
  • Valve replacement: 290
  • Mitral valvuloplasty: 113
  • Congenital disease operations: 450
  • Others: 287.

Mattia Glauber

Years of experience: 25

Head of Unit - Cardiac Surgery - Istituto Clinico Sant'Ambrogio

Internationally renowned heart surgeon specialized in minimally invasive cardiac surgery.

CLINICAL ACTIVITY
450 cardiac surgery interventions, including:

  • Aortic valve replacement: 200 cases per year
  • Mitral valve interventions: 150 per year.