With its complex and expensive treatment the heart is the leading health concern of the modern world. Yet one of the strongest areas of Turkish Healthcare and Orion Healthcare Division Solution Partners is cardiac treatment. Cardiology services starting from diagnosing, examining, intervention, intensive care and rehabilitation are served with enhanced levels of know-how and state of the art technology. A board range of pediatric and adult cardiac surgeries are performed by world class Turkish surgeons. Coronary angioplasty and stent cases, by-pass surgeries are offered non-invasive high tech diagnosing procedures like electro cardiography, ecocardiography, computed tomography (CT), magnetic resonance imaging (MR). With 2×64 CT scans instant diagnosis of the heart is possible with a high quality outcome compared with angiography and conventional diagnostic modalities. Cardiovascular surgeries performed last years exceed 10.000 cases as well as 30.000 cases of all kinds of interventional cardiology in the leading accredited hospitals. Complex coronary by-pass surgeries can be performed with the help of impella micropump device on beating heart in Turkey since 2008. First Turkish cardiac pump “Heart Turcica” and biodegradable drug eluding coronary stands were also developed and being tested in high Turkish research centers.
In Orion Healthcare Division solution Partner’s Thoracic and Cardiovascular Surgery Department, adult heart surgeries, mostly coronary bypass surgery are performed.
Coronary bypass surgery
In coronary bypass operations, generally three or more veins are interrupted. Duration of surgeries varies according to the number of veins to be applied as well as additional interruptions, but it is 4 hours on average. The patient wakes up completely 4-6 hours after he/she was taken to intensive care and respiratory support apparatus is removed. Patients can generally start to meet their individual requirements within a week and begin to live on their own within 2-3 weeks after coronary bypass surgeries. In such surgeries, mammary and radial artery of patients is routinely used (full arterial bleeding). Leg vein is the third choice all the time. Mortality rate in coronary bypass surgeries at Orion Healthcare Division solution Partner Cardiovascular Surgery Department is below 1%. (This rate ranges from 1 to 3% in the developed countries across the world). Occurrence of infection is below global standards. As a principle, we ensure that the patient underwent bypass passes through exercise test once a year and coronary angiography 5 years following the surgery. Request for flat coronary bypass surgery is very rare at our hospital.
The cases are comprised of valve, cardiac aneurism and aortic aneurism at various levels or secondary organ problems (kidney, lung etc.) and the problems of complicated elderly patients. Second operations of the patients
who underwent a heart surgery previously are frequently performed by our re-operation unit. Cardiology and intensive care team is specialized in this area along with surgery team. Application of robotic surgery technology, which was previously introduced in coronary
bypass surgeries, but early results of which are not promising, was ceased in line with global practice.
Conservative treatment in bypass surgery
If there is any leakage in mitral valve in bypass surgeries performed at Orion Healthcare Division solution Partner Cardiovascular Surgery Department, plasty application is made and further damage of valve is prevented.
Heart Valve Surgeries
At Orion Healthcare Division solution Partner’s Thoracic and ardiovascular Surgery Department, “Mitral” and “Aortic” valve surgeries are very frequently performed. With the advance of education level in Turkey, decrease took place in the number of heart valve disorders related with rheumatism. Therefore, surgeries are mostly intended for treatment of disorders related with calcified valves that occur at a further age. Rhythm disorders (atrial fibrillation) which are observed in Mitral Valve surgeries very frequently are fixed through radiofrequency ablation, which is a very special method. This method is applied only at several centers in our country. Mending methods intended for valve are preferred in patients with mitral valve disorders. Biologic valves are used for young women who would like to give a birth or for the elderly patients who would have trouble in using anticoagulant drugs.
Large aorta surgeries
In large aorta surgeries, Endovascular Surgery i.e. Endograft is primarily preferred. Like 1 mm stents placed into cardiac veins, stents with diameter of 2 to 3 cm are successfully implanted into thoracic and abdominal aorta. This operation is carried out in conjunction with Invasive Radiology Department and we are proud of being the most experienced team in this field in our country. Besides, operation methods, in which the whole aorta is replaced in large aorta aneurisms, are used.
Surgeries for leg arterials and varicose veins
Varicose disorder, which is the mostly observed disease among vascular diseases, is related with veins and, for the patients who could not be applied sclerotherapy, medical operation is performed. In Orion Healthcare Division Solution Partner’s Vascular Surgery Department, successful bypass surgeries are realized on abdominal aorta and leg arterials. Artificial veins are used in such operations.
Sclerotherapy for Varicose Veins (Injection Therapy)
Injection therapy may be realized without hospitalization. In some cases, while it may be used as a supplementary treatment after the surgery, it is also utilized in the treatment of relapses. Micro varicose is treated by laser at our dermatology department.
The risk of occurrence of atherosclerotic disease of carotid artery is very high in the patients with coronary heart disease. (8 – 12%). Therefore, it is vital that carotid arteries of each patient who are over the age of 40 and who have to undergo coronary bypass surgery are reviewed by color Doppler ultrasonography. In the patients whose congestion has been detected to be above 70-80% prior to operation, carotid arteries are both operated on prior to heart surgery and together with (in special circumstances) heart surgery. In this operation, hard plaques that congest carotid artery are cleaned up and expanded by patch. Our team is very experienced in this field.
Orion Healthcare Division Solution Partner’s Thoracic Surgery Department serves as a team chaired. For the patients prepared at Lung Diseases Department (who have undergone bronchoscope and respiration tests), all kinds of lung operations and tumor staging. As lung operations related with infections and bronchial deformities have today nearly terminated, the operations performed are mostly tumor surgery.
Special methods of treatment
A classical angiography applied to a patient is reviewed in three dimensions on a special computer program. Orion Healthcare Division Solution Partner’s Thoracic and Cardiovascular Surgery team utilizes 9-zoom medical glasses in coronary bypass surgeries. Bypass control after bypass surgeries are realized by thermal cameras. The team is the ‘only team’ that uses these applications in Turkey.