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Cardiosurgery

Information about the centre

The Cardiosurgery Department treats a wide range of pathologies. We offer a broad range of top quality surgery, including full arterial revascularisations for coronary surgery (over 25 years’ experience), repair of aortic and mitral valves with degenerative disease (>95%), a full range of valve replacement techniques (ross, homograft, stentless etc.), a heart-transplant programme (primarily artificial hearts), paediatric and congenital surgery and endovascular unit for stent graft.

Equipment

The Cardiosurgery Department have:

  • 4 cardiovascular operating rooms including 1 hybrid operating room (It is the first time in Europe such high-tech equipment tools are  installed in an operating block). Read more (press release in French).

  
Clin. Univ. St-Luc / H.Depasse

  • A Robot to help the surgeon to be the most effective and the least invasive possible
  • 24 beds of intensive care
  • 54 beds of hospitalisation

The medical chief

Gebrine El Khoury, MD, PhD, is recognised as a pioneer in aortic-valve repair.
(see CV-Pr-G-El-Khoury)

He and his team run what has become a key centre in the treatment of valve disease; the centre is now considered as a true authority on cardiac surgery, as illustrated by its many daily visitors, its active involvement in high-level international conferences (live surgery, lectures, postgraduate courses, etc.) and the organisation of three international meetings each year.

Procedures Performed

Valve Surgery : Aortic, Mitral and Tricuspid Valve Reconstruction

Aortic valve repairs have been performed at the Cliniques universitaires Saint-Luc. The Cardiosurgery Department is a real pioneer in this particular field and a world leader in this type of surgery. We have gained a great experience over mitral-valve. Our expertise in this field is internationally recognised and we have developed specific techniques which are now used worldwide.

For more than a decade, our department has provided post-graduate courses for both aortic valve replacement and mitral valve repair/replacement twice a year.

Technology: da Vinci Surgical System ®

For most patients, the mitral da Vinci valve repair can offer many potential advantages compared to an open heart surgery, including :

  • Shortened hospitalization
  • Less pain and reduced healing time
  • Decreased risk of infection
  • Reduced blood loss and less need for blood transfusions
  • Faster recovery
  • Quicker return to daily activities
  • Less invasive surgery

As in any surgery, these benefits cannot be guaranteed, because any operation is different  from patient to patient and according to the procedure used.

The da Vinci Surgical System® is based on advanced robotics technology. Thanks to the device, the hand movements of your surgeon may be evaluated, filtered and translated into controlled movements of micro-instruments within the operative area.

The da Vinci enhances surgical capabilities by enabling the realization of complex interventions through small incisions. The device cannot be programmed and cannot make decisions alone. With the da Vinci System®, every surgical operation must be performed with direct input from your surgeon.

The da Vinci Surgical System® has been used in tens of thousands of minimally invasive interventions throughout the world.

Percutaneous Aortic Valve Replacement

Aortic valve stenosis is the very common pathology concerning elderly patients. The conventional treatment is an open-heart surgery with replacement of the aortic valve using extracoporeal circulation and cardiac arrest. However according to the European Heart Registry, 32% of symptomatic aortic stenosis patients are not referred to surgery because of the operation risk due to the age and the different co-morbidities of the patients. For this reason, a new technique was developed, which consists in percutaneous aortic valve replacement under local anaesthesia without extra-corporal circulation. The valve is delivered at the right place through a catheter-based system.

Our Department was one of the first in Belgium to launch a trans-catheter valve-replacement programme.

We have already performed either trans-femoral or trans-apical procedures with an excellent post-procedural results. Today, both general practitioners as cardiologists from all over the country refer many patients to our centre for endovalve treatment even though this procedure is still at its beginning, with an undisputable learning curve. Obviously, this still expensive technique requires a strict and objective evaluation before being made available to the whole community.

Coronary Surgery :

- Multi-arterial Coronary Bypass Surgery (CABG)

For more than two decades (since 1985), our group has been pioneering the multi-arterial coronary artery revascularisation technique which has now been recognised to promote long-term survival.

Several scientific works have been published by our surgeons and several international meetings on this topic have been organised as well. Currently, we perform more than 50% of all our revascularisation procedures using 2 or more arteries.

- Minimally Invasive Coronary Bypass Surgery (MIDCAB)
Since the launch of our Minimally Invasive Coronary Bypass Surgery programme in 2003.

This type of surgery is realised by video-thoracoscopy to harvest the left and right internal thoracic arteries. The anastomoses are performed through a small left anterior thoracotomy. We have recently analysed and published our experience with this innovative technique that shows similar patency results in term of by-passes and shorter time to recovery.

We have also introduced the minimally invasive coronary surgery for second operation in selected patients in whom the gastro-epiploic artery is used to revascularise the right coronary artery with a small (10 cm) midline laparotomy.

Endovascular Treatment of Arterial Diseases

The treatment of the different aortic diseases such as aortic aneurysm, aortic dissection, traumatic rupture… located on the thoracic or abdominal aorta often need an invasive open treatment by laparotomy and/or thoracotomy. The alternative treatment is to deploy an endograft by only a small grown incision.

Our Department is one of Belgium’s leading units in the endovascular treatment of aortic disease. We started the endovascular programme in 1996 and have since treated a lot of abdominal aortic aneurysms and thoracic aortic diseases using the endovascular method. Our clinical results are excellent and comparable to the world medical literature.

For the occlusive disease of peripheral artery and carotid artery, we also initiated in 1996 the endovacular treatment of occlusive disease by iliac and femoro-popliteal angioplasty and/or stenting. More recently, we have conducted comparative studies on both open and endovascular carotid revascularisation. Importantly, all our carotid stenting are registered in the international multi-centric studies. We participated to both the ICSS protocol and ASCT protocols. Those registries are mandatory to allow in-depth analysis and discussion on the appropriate use of such innovative procedures in comparison to surgical gold standards.

Surgical Treatment for Heart Failure Patients

Our artificial-heart programme was launched in 1992. In 1995 we were recognised as one of the European training centres for the implantation of the first-generation left ventricular assist device (LVAD).

Our department has followed the ongoing technological development in this high-tech field and is currently using LVAD of the second and third generation. Current and future indications for these devices are bridge to recovery, bridge to transplantation and finally long term or definitive placement for patients who are not eligible for transplantation.

Pathology Numbers per year
Valve Surgery
Aortic, Mitral and Tricuspid Valve Replacement 500 per year
Aortic valve repair 100 per year
Mitral valve repair 150 per year
Percutaneous Aortic Valve Replacement 40 per year
Endovascular Treatment of Arterial Diseases Abdominal aortic aneurysm: 50 per year
Coronary Surgery CABG multi-arterial coronary bypass surgery 400 per year
Surgical Treatment for Heart Failure Patients 10 implantable LVAD per year