To care for your heart, we have a multidisciplinary team who specialise in preventing, diagnosing and resolving any cardiovascular problems, however complicated they may be.

Cardiologia
Cardiología_blancoCardiología_negro

Heart Department

Our Heart Department is both staffed by a medical team with extensive experience in the diagnosis and treatment of coronary and cardiac diseases which can be treated percutaneously, and equipped with cutting-edge high technology, since we have hybrid operating theatres where surgeries on structural cardiac conditions are performed to the highest safety standards.

Key areas of Heart Department
Cardiovascular surgery

The Cardiac Surgery Unit has been a leader in the surgical treatment of adult cardiac disease for more than 15 years, and the members of the cardiac surgery group have performed open-heart surgery on more than 5,000 patients with outstanding outcomes. We seek to deliver the best surgical solutions, including for people who have been rejected by other hospitals or who require very complex surgery because they are high and very high risk patients.

Our Smart Cardiac Surgery Program involves a stringent quality control of the highest standards throughout the surgical procedure (preoperative, intraoperative and postoperative), which makes it one of the most advanced cardiac surgery protocols available today worldwide. A highly experienced team of heart specialists works using a holistic multidisciplinary process, which is based on the highly sought after patient-centered approach.

The Smart Cardiac Surgery Program includes beating heart coronary surgery, minimally invasive cardiac surgery, bloodless cardiac surgery and fast-track recovery.

Our program is governed by the most rigorous and disciplined practices of healthcare quality management, focused on providing the best patient care and satisfaction with maximum safety.

  • Our team is committed to excellence and our goal is to provide the best care to our patients and their families.

  • At present, cardiac surgery can be performed with minor surgical aggression, with excellent results and a very low risk for the patient.
Cardiac Haemodynamics

Our Interventional Cardiac Haemodynamics Unit has an experienced team of professionals who use next-generation technology to diagnose and treat coronary and cardiac conditions. We conduct high-precision studies in state-of-the-art laboratories. In recent years, haemodynamics has developed percutaneous techniques to treat aortic and mitral valve conditions (percutaneous aortic valve prosthesis, leak closures) or congenital malformations (fixing short circuits), that just a few years ago, needed surgical correction. We can deal with more and more conditions without the need for open surgery. Without doubt, the ideal environment for carrying out this type of treatments is the hybrid operating theatre, which unites the sterile conditions of the surgical environment with the most advanced X-ray technology. Without doubt, the ideal environment for performing this type of treatments is the hybrid operating theatre, which unites the sterile conditions of the surgical setting with the most advanced X-ray technology. During the procedures, we also add the overlapping of images taken by other techniques (ultrasound, echocardiography, Echo Navigator, CT scan, and Heart Navigator) for better precision.

  • We have a hybrid operating theatre, which unites the sterile conditions of the surgical environment with the most advanced X-ray technology.
  • For the diagnosis and treatment of coronary heart disease, we conduct high-precision studies in state-of-the-art laboratories.

Paediatric cardiology

With over 35 years’ experience and over 10,000 heart defects operated, our team of specialists deals with all types of congenital heart defects from neonatal age to adults with congenital problems. 70% of the heart defects that we treat are complex, with an Aristotle Basic Score of 8.2, which is higher than the European average, and with a survival rate of 98.2%.

  • Over 10,000 heart defects operated, 70% of which are of maximum complexity. We operate on all kinds of heart defects, including those in Group 4 of the Aristotle Basic Score
  • Personalised care with a 1:1 doctor-patient relationship
  • International experts for complex congenital heart defects. We provide medical assistance to patients from several countries.
Arrhythmias

Our arrhythmia experts conduct electrophysiological studies with high-performance equipment for diagnostic and therapeutic purposes. They treat patients that have been previously diagnosed and referred by Cardiology or Internal Medicine specialists to the Electrophysiology and Arrhythmias Department for treatment.

Our specialists perform ablations, arrhythmia studies, pacemaker implant and monitoring treatments, electric cardioversion, tilt table tests to study syncope, as well as arrhythmia Holter monitoring and pressure Holter monitoring

  • Some of our centres perform the most ablations to treat atrial fibrillation, with a higher volume than some of the country’s main centres.
  • Thanks to our experience and the use of next-generation technology, we provide a personalised and precise medicine.

Tratamientos quirúrgicos

Diseases, treatments and techniques
  • Reparación-de-la-válvula-mitral
    Mitral Valve repair

    Mitral valves can be repaired without the need for substitution or replacement. In patients with mitral valve prolapse, our success rate in avoiding mitral valve replacement approaches 100% with very low risk

    Cardiovascular surgery
  • Cirugia-cardiaca-sin-sangre
    Bloodless cardiac surgery

    Bloodless heart surgery is transfusion-free cardiac surgery, where the patient’s wishes are respected based not only on religious beliefs but also with the intention of trying to avoid the potential risks associated with blood transfusions, such as infections, complications and mortality. Our bloodless cardiac surgery team has become an international benchmark in treating patients from all over the world

    Cardiovascular surgery
  • Cirugía-mínimamente-invasiva
    Minimally invasive cardiac surgery

    Traditional heart surgery typically requires exposure of the heart and its vessels through median sternotomy (dividing the breastbone) and a 6 to 8 inch incision. Minimally invasive heart surgery (also called keyhole surgery) is performed through small incisions, sometimes using specialized surgical instruments. The incision used for minimally invasive heart surgery is about 3 to 4 inches.

    The benefits of minimally invasive techniques include:

    • Small incisions and small scar.
    • Shorter hospital stay after surgery.
    • Low risk of infection.
    • Less postoperative pain.
    • Low risk of bleeding and blood transfusion.
    • Shorter recovery time and faster return to normal activities/work.
    Cardiovascular surgery
  • Reemplazo-de-válvula-aórtica
    Aortic Valve replacement with sutureless valves

    Sutureless aortic valves, the alternative to traditional and transcatheter valves,were designed to simplify and significantly accelerate the surgical replacement of a diseased valve and first require complete excision of the calcified native valve. Shortening the time required for aortic valve replacement may help to reduce morbidity and mortality, especially in patients who require complex multivalve or combined valve and coronary procedures

    Cardiovascular surgery
  • Procedimiento-de-Ross
    Ross procedure

    The Ross operation is an extremely complex procedure developed for individuals who require a new aortic valve. In the Ross procedure, the diseased aortic valve is removed and replaced with the patient’s own pulmonary valve (autograft). After the pulmonary valve is transferred to the aortic position, a pulmonary homograft from a donor (human cadaver) valve is sewn into the pulmonary position, and the coronary arteries are re-mplanted. The Ross procedure is especially well suited to young individuals.

    Advantages of the Ross procedure

    • Anticoagulants (blood thinners, such as Warfarin) are not necessary. Blood thinners increase the risk of bleeding, and may lead to a stroke or other medical problems. In addition, blood thinners cannot be used in women who may become pregnant as they cause severe damage to an unborn child.
    • Thromboembolic complications are near zero.
    • The risk of endocarditis is reduced.
    • The natural valve is superior in hemodynamics to prosthetic or bioprosthetic valves.
    • The autograft has the potential to grow as the child grows (which artificial valves cannot do).
    • Patients’ activities do not need to be limited.

    Ross procedure candidates are:

    • Infants
    • Young people who are very active and do not want to take blood thinner medication for the rest of their lives
    • Young women who want to become pregnant
    • Middle-aged active people
    Cardiovascular surgery
  • Extubación-inmediata
    Immediate extubation in OR after cardiac surgery: ( “ ultra-fast-track-recovery”)

    Cardiac surgery is the only type of elective surgery where routine immediate extubation is not considered a routine procedure. Immediate extubation still challenges conventional practice; therefore, it should be performed in an environment where surgeons, perfusionists, nurses, and respiratory technician are all involved in this endeavor. We routinely extubate after cardiac surgery.

    Why Do It? Positive pressure ventilation is not beneficial for recovery after cardiac surgery since it reduces the venous backflow, can make certain pulmonary complications such as pneumothorax or hemothorax worse.

    Cardiovascular surgery
  • Cierre-del-foramen-oval-permeable
    Closure of patent foramen ovale

    Cause of cryptogenic strokes, often in younger patients

    Cardiac Haemodynamics
  • comunicación-interauricular
    Closure of atrial septal defects

    And closure of the left atrial appendage, aimed at patients at risk of embolic stroke due to atrial fibrillation, but who cannot follow an anticoagulant treatment due to high probability of haemorrhage.

    Cardiac Haemodynamics
  • fugas-periprotesicas-(leaks)
    Closure of periprosthetic leaks
    Cardiac Haemodynamics
  • Valvuloplastia-aortica-o-mitral
    Aortic or mitral valvuloplasty
    Cardiac Haemodynamics
  • Ttrascateter-de-válvula-aortica-(TAVI)
    Transcatheter aortic valve implantation (TAVI)

    Aimed at such a large group of patients with serious degenerative aortic stenosis, who are considered to be at high or prohibitive surgical risk, as well as an alternative therapy for patients at intermediate risk. We have been performing this type of operation weekly in our hybrid operating theatre.

    Cardiac Haemodynamics
  • Reparacion-valvular-mitral
    Mitral valve repair with Mitraclip

    For those patients with functional severe mitral regurgitation.

    Cardiac Haemodynamics
  • Cirugía-neonatal
    Neonatal surgery

    We have a prenatal diagnosis programme for both national and international patients; international patients are consulted through telemedicine. We have a Mother and Child Service with Obstetrics and Neonatology that is highly specialised in treating heart defects. All types of neonatal heart defects are treated, including those in premature and underweight babies. Extracorporeal circulation techniques are used, which are dedicated to maintaining organ perfusion, which guarantees low morbidity rates. A 7-day stay and approx. 96% survival rate.

    • Hypoplastic left heart syndrome.
    • Total anomalous pulmonary venous drainage.
    • Hypoplastic aortic arch.
    • Interrupted aortic arch.
    • Truncus arteriosus.
    • Pulmonary atresia.
    Paediatric cardiology
  • Atresia-pulmonar
    Pulmonary atresia with ventricular septal defect (VSD) and major side effects

    Pulmonary atresia with ventricular septal defect (VSD) is a rare congenital heart defect. Highly complex and with a group 4 ABS, the main aim is to establish a single source of pulmonary blood flow, unifocalising the collaterals, closing the VSD and implanting a valved conduit between the RV and PA.

    We are international experts, performing the 3 main types of procedure: 1) unifocalisation in the first year of life, 2) staged repair of PA, 3) repair of PA using hybrid procedures (Interventional Haemodynamics), depending on the anatomic type.

    At the end of treatment, 90% of patients have VSD closure and a survival rate 96%. These results make us stand out at an international level.

    Paediatric cardiology
  • Tetralogía-de-Fallot
    Tetralogy of Fallot with pulmonary valve preservation and hybrid treatment

    Tetralogy of Fallot is a complex congenital heart defect that takes many forms and can be treated from neonatal age to adulthood.

    The main aims are to establish sufficient pulmonary flow, VSD closure, and pulmonary valve preservation, using hybrid techniques of interventional catheterisation during surgery, which enables the dilation of the pulmonary valve annulus with a balloon, avoiding cutting it and enabling the preservation of the pulmonary valve, thus preventing the need of further operations in adulthood. In 95% of cases, we preserve the pulmonary annulus with a z score of -3.

    Paediatric cardiology
  • Trasposición-grandes-arterias
    Transposition of the Great Arteries (TGA)

    It is the most common heart defect that requires surgical treatment at neonatal age.

    Our centre performs an arterial switch in all patients with TGA regardless of their coronary pattern.

    Complex TGA:

    • TGA with VSD
    • TGA with hypoplastic aortic arch and/or coarctation of the aorta (CoA) and
    • TGA with pulmonary stenosis (PS)

    We perform all kinds of techniques to anatomically correct this defect, including the Rastelli and Nikaidoh procedures for TGA, VSD and PS.

    Paediatric cardiology
  • Enfermedades-valvulares
    Valve defects

    This is one of the challenges of the speciality, since suitably sized valve prostheses for small patients do not exist. At our centre, we are very experienced in performing aortic valvuloplasty for aortic stenosis in neonatal age. Different aortic and mitral valve reconstruction techniques are used in patients under one year old, with valve preservation with an average of 10 years without the need to re-operate.

    The surgical team is one of the most experienced and has the best results at European level in the Ross and Ross-Kono procedures, including in infant and neonatal age patients.

    Paediatric cardiology
  • Corazón-univentricular
    Functional or anatomical univentricular heart Surgical treatment

    Highly complex heart defects, where there is only one functional ventricle, and after various surgical treatments, patients end up having the Fontan circulation procedure. The surgical team was one of the pioneers in using the extra-cardiac Fontan procedure in Europe (C. Marcelletti procedure), gathering one the largest case studies. In cardiac malpositions, reconstruction of the tunnel with an intra/extra-cardiac conduit is used with very good results. This technique is performed in very few centres at present.

    Paediatric cardiology
  • Tratamientos-híbridos
    Hybrid treatments

    We have a highly specialised team of interventional haemodynamics specialists who, together with the surgical team, deal with all tributary conditions with this type of treatment. E.g. Apical VSD, stent insertion, pulmonary valve implants, among others.

    Paediatric cardiology
  • Fibrilación-auricular
    Atrial fibrillation

    Atrial fibrillation is the most common arrhythmia and is one of the largest causes of stroke, heart failure, sudden death and cardiovascular problems. It is a cardiac rhythm disorder that causes heartbeats to be irregular, inappropriately fast and not adapted to the needs of the body. This rhythm disorder results in the formation of, among other things, blood clots in the heart, which can produce embolisms in the brain and other organs.

    It is estimated that in the year 2030, there will be between 14 and 17 million people with atrial fibrillation in the European Union, with between 120,000 and 215,000 new patients diagnosed each year.

    The main complication is cerebrovascular accident (stroke), due to blood clots that form in the heart when it has atrial fibrillation, and which would not form if the arrhythmia was not present. Another significant complication is the development of heart failure, which occurs in 1 in every 3 patients diagnosed with atrial fibrillation during follow-up. Mortality is doubled in patients with both atrial fibrillation and heart failure.

    Although it can be initially treated with anti-arrhythmia drugs, these do not cure it and only decrease the frequency of the attacks in some cases, but they cannot prevent them. Therefore, patients often opt for treatment through ablation. Ablation is a cardiac catheterisation, through which pulmonary veins are isolated. Ablation has better results that pharmacological treatment for preventing new episodes of arrhythmia.

    Arrhythmias
  • Arritmias-ventriculares
    Ventricular arrhythmia

    Thanks to our research activity and the application of the latest techniques for treating ventricular arrhythmia, we can better identify patients who are at greater risk of sudden death among those who suffer from a structural heart disease or heart failure. Until now, when these patients underwent treatment for heart failure, a device was implanted, which can either work by only re-synchronising the heartbeats or, as well as re-synchronising, can defibrillate. However, the clinical criteria for deciding one option or another are quite vague, and this results in some patients not being sufficiently protected because they have an implant that can only re-synchronise.

    However, this decision can be made in a much more precise way thanks to cardiac nuclear magnetic resonance. We are entering into what is called personalised and precision medicine. In this way, it is checked whether there is scar tissue on the heart and, if so, if it is very extensive. If so, the model with defibrillator is chosen, and if not, the simpler model is chosen.

    It is not the only case in which resonance ends up being a determiner in the treatment of these patients. The procedure for performing an ablation in patients with ventricular arrhythmia is very complex and requires a lot of preparation. Now it is possible to carry out a resonance beforehand and, thanks to data post-processing, we can see the electrical channels in the scars. These channels are what sustain ventricular arrhythmia and being able to see them helps to make ablations quicker, easier to perform, and more successful.

    Arrhythmias