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Cardiac surgery is a specialty that deals with the surgical treatment of heart diseases. These include coronary artery disease, valvular heart disease, aortic disease, congenital heart disease, as well as surgical procedures performed for cardiac arrhythmias.

Endoscopic cardiac surgery

Endoscopic cardiac surgery is the most modern development of cardiac surgery and aims to perform all of these procedures completely endoscopically, using high-resolution three-dimensional imaging, with small incisions of one to two centimeters in length in the lateral chest wall. In this way, the median sternotomy, which is a large and painful incision, is avoided. At the same time, the length of hospital stay and the time away from work and full activity are significantly reduced. Needless to say, endoscopic cardiac surgery has an excellent cosmetic result with almost invisible incisions.

In recent years, our country has become a global center for endoscopic cardiac surgery. Specifically, at the First Cardiac Surgery Clinic at the Inter-Balkan Medical Center of Thessaloniki, all mitral, tricuspid and aortic valve surgeries are performed completely endoscopically, as well as the majority of congenital heart disease surgeries, aortic diseases and coronary artery bypass grafting.

Our extensive experience, over 15,000 heart surgeries, our extensive writing and participation in the most specialized surgical forums, as well as the international recognition of our work in the form of teaching endoscopic cardiac surgery in dozens of centers abroad and training cardiac surgeons in our clinic, is proof of the great acceptance of endoscopic cardiac surgery worldwide.

Endoscopic mitral valve repair (TEMVr)

Mitral valve surgery is the most common endoscopic procedure. In the majority of cases, the diseased mitral valve is repaired, giving the patient the advantage of maintaining his own valve, without the need for long-term anticoagulants. A wide range of mitral valve repair techniques, depending on the pathology, have been developed and include mainly the techniques of sealing the valve with neochordates, with extremely high success rates and long-term good valve function. Regardless of the type of pathology, it is necessary for the surgical team to know the pathology and the repair strategy from the beginning in order to achieve the desired result.

Endoscopic aortic valve replacement (TEAVR)

Total endoscopic aortic valve replacement (TEAVR) has been developed in recent years and is applied exclusively in Greece at the First Cardiac Surgery Clinic of the Inter-Balkan Medical Center of Thessaloniki.   The surgical advantages compared to TAVI are the removal of the diseased valve, the cleaning of the aortic annulus and the accurate measurement of the valve diameter, while the rates of paravalvular regurgitation and atrioventricular node blockade are zero. In addition, postoperative pain, the need to stay in the Intensive Care Unit and in the hospital are drastically reduced, with the patient returning to work more quickly and maintaining an excellent cosmetic result.

Endoscopic treatment of adult congenital heart disease

The majority of adult congenital heart disease and more often the repair of all types of atrial septal defect can be performed endoscopically, with surgical opening of the left and right heart chambers, depending on the condition, and repair of the defect, with three-dimensional vision that allows for optimal study in space, identification of the pathology and appropriate repair. In the majority of procedures for adult congenital heart disease, the endoscopic approach is the same as that for mitral valve procedures.

Endoscopic Coronary Artery Bypass Graft (TECAB)

Coronary artery bypass grafting is the most common and studied cardiac surgery and is the surgery of choice for multivessel coronary artery disease. In recent years, complete endoscopic coronary artery bypass grafting has been applied in several centers around the world, with the use of one or both internal thoracic arteries.

This technique allows bypassing all coronary arteries, offering excellent visualization of the target vessels, while, due to the avoidance of placing a partial occlusion clamp in the ascending aorta, the risk of complications is significantly reduced postoperative neurological problems to a significant extent.

Endoscopic coronary artery bypass grafting is always combined with endoscopic venous grafting and radial artery grafting. In this way, coronary artery bypass grafting, with its undeniable advantages over percutaneous coronary intervention (PCI), is regaining the lost ground of cardiac surgery in coronary artery disease, minimizing surgical trauma and the number of days the patient spends in the hospital.

Endoscopic treatment of atrial fibrillation

Atrial fibrillation is a heart arrhythmia that affects a large part of the population and in many cases is highly resistant to both medication and modern endovascular approaches, with high rates of recurrence. Now, endoscopic treatment of atrial fibrillation is possible in extremely high rates, with long-term results and minimal incisions in the chest wall.

At the 1st Cardiac Surgery Clinic of the Inter-Balkan Medical Center of Thessaloniki, all patients with atrial fibrillation are treated endoscopically, either in combination with another surgical heart condition, or even as cases that concern the treatment of atrial fibrillation exclusively.

Dr. Antonios Pitsis is a founding member and permanent member of the Board of Directors of the Endoscopic Cardiac Surgeons Club (ecsclub.org)