SPITALUL CLINIC DE URGENȚĂ BUCUREȘTI - SECȚIA CLINICĂ DE CHIRURGIE CARDIOVASCULARĂ

Brief History:

The organized cardiovascular surgery activity at the Bucharest Emergency Clinical Hospital began in 1993-1994 with the arrival of Prof. Dr. Ilie Pavelescu and later a few collaborators. During this time, vascular surgery started, initially addressing vascular trauma, abdominal aortic aneurysms, peripheral surgical revascularizations, surgical vein pathology, and emergency cardiac wound suturing. The vascular surgery unit was transformed into the Cardiovascular Surgery Department in 1998 when Dr. Șeban Brădișteanu, a Grade I scientific researcher, took over leadership.

He modernized the existing infrastructure and performed Romania's first heart transplant at this hospital on October 24, 1999. In 2021, the department became a University Clinic affiliated with UMF "Carol Davila" Bucharest, under the leadership of Prof. Dr. Habil. Horațiu Moldovan. The academic university team includes a head of works and five university assistants, along with other cardiovascular surgeons, cardiologists, and anesthesiologists.

Infrastructure:

The Clinical Cardiovascular Surgery Department of the Bucharest Emergency Clinical Hospital includes a modern operating block with two fully equipped operating rooms for advanced cardiac surgery and heart transplants, an ICU unit (A1 class) with 10 beds, and a ward with 35 beds, 10 of which are designated for vascular surgery.

The team consists of six primary cardiovascular surgeons, two primary vascular surgeons, three primary cardiologists (one of whom is also qualified in interventional cardiology), three specialist anesthesiologists, and 20 cardiovascular and vascular surgery residents at various stages of professional training.

Academic-University Activity:

In 2021, the Cardiovascular Surgery Clinic of UMF “Carol Davila” was established, currently consisting of:
• 1 habilitated professor
• 1 head of works
• 5 university assistants

They provide lectures and practical courses in cardiovascular surgery for fourth-year medical students in the cardiology module. They also organize and conduct cardiovascular and vascular surgery residency programs, as well as vascular surgery training modules for residents of other surgical specialties. In addition, they oversee 11 PhD students and support diploma theses for students.

Scientific Activity:

Scientific output includes the consistent publication of over 40 articles in the ISI-indexed scientific stream (Web of Science) since the clinic’s founding in 2021 and participation in prestigious national and international congresses such as SRCCV (Romanian Society of Cardiovascular Surgery), SRCV (Romanian Society of Vascular Surgery), SRC (Romanian Society of Cardiology), EAST Meets WEST, EACTS (European Association for Cardio-Thoracic Surgery), and ESOT (European Society of Organ Transplantation).

Surgical Activities:

• Aortic root reconstruction and aortic valve repair (uni-, bi-, tri-, quadracuspid).

• Aortic arch surgery in rapid deep hypothermia.

• Minimally invasive surgery techniques for cardiac valvulopathies.

• Mitral valve repair techniques (neochords, annuloplasty, cusp repairs, etc.).

• Surgery for chronic obstructive cardiomyopathy.

• Coronary artery surgery on a beating heart, "off-pump," "full arterial," "aorta no touch."

• Hybrid revascularization, CABG using the routine internal mammary artery graft.

• Treatment of end-stage heart failure by resuming the cardiac transplant program (the Bucharest Emergency Clinical Hospital being the first heart transplant center in Romania) and introducing ventricular assist devices (LVAD – long-term home circulatory support) as well as treatments via ECLS/ECMO.

• Management of an increasing number of major cardiac emergencies: aortic dissections (10-15 cases/year), pulmonary thromboembolism, post-infarction mechanical complications (papillary muscle rupture with acute mitral insufficiency, free ventricular wall rupture, post-infarct VSD), acute infective endocarditis on native or prosthetic valves.

• Treatment of aortic stenoses with surgical contraindications or inoperable cases using transcatheter structural heart techniques (through three different access routes: femoral, axillary, or apical) and using various valve prostheses (Edwards Sapiens, Navitor, Meril-Myval), with specific indications and limitations for each type.

• Transcatheter therapeutic techniques for mitral insufficiency (Mitraclip), tricuspid insufficiency (Triclip), and transcatheter pulmonary valvulopathies.