Pediatric Cardiac Surgery and Cardiology

The Department of Pediatric Cardiac Surgery with Cardiology of Acibadem Sistina Hospital is the first fully equipped and staffed pediatric cardiac surgery center in the country providing diagnosis and treatment for children with congenital and acquired heart defects aged 0 to 18 years. In a modernly arranged space, it has an Inpatient Ward and Cardiac Surgery Intensive Care equipped with the most modern medical technology that enables highly professional 24-hour care and monitoring of patients. The health of the children is taken care of by an experienced team consisting of cardiac surgeons, pediatricians with experience in pediatric intensive care, pediatric cardiologists, cardiac anesthesiologists, cardiac perfusionists and nurses trained in the field of pediatric cardiac surgery. The Cardiac Surgery Department also includes Pediatric Intensive Care, consisting of 7 pediatric intensive care units and 7 pediatric cardiac surgery units built in compliance with world protocols.

Thanks to its multidisciplinary approach, infrastructure, staff and technological equipment, the Department provides integrated care for cardiac diseases, from accurate diagnosis (prenatal and/or postnatal) to final treatment, including post-surgical intensive care, which is a rarity in the hospitals in the region. The Department provides surgical treatments for the full range of congenital heart defects, which are usually performed in the first year of life, as well as further monitoring of the patients.

With its infrastructure and staff, for the first time in our country the Department will be able to provide healthcare in the field of pediatric surgery and pediatrics to all children in need of intensive care and resuscitation, from their earliest age up to 18 years.

For the citizens of Macedonia, all cardiac surgery services of the Department are covered by the Macedonian Health Insurance Fund.

PEDIATRIC CARDIAC SURGERY REFERENCE CENTER IN THE REGION

Our doctors cooperate with doctors from the Acibadem Healthcare Group hospitals, Turkey, who have an extensive experience of over 15,000 cardiac surgeries behind them. Thanks to their support, the Department of Pediatric Cardiac Surgery aims to replicate the successful experience of the Acibadem hospitals, Istanbul, and to grow into a reference center for cardiac surgery patients from across the region.

CARDIAC SURGERY INTENSIVE CARE

The Intensive Care Unit consists of 7 pediatric intensive care units and 7 pediatric cardiac surgery units. Each unit is equipped with invasive monitors displaying vital parameters, connected to a sophisticated central monitoring system that enables monitoring from multiple locations in the Department. Each intensive care unit contains an adequate central gas supply system with the possibility of placing the patient on mechanical ventilators suitable for invasive and non-invasive ventilation. Each unit contains a sufficient number of state-of-the-art perfusors, infusometers, humidifiers, heaters, echotomography machine, gas analyzers, ACT machines, latest technology dialysis machines for children, defibrillators, pacemakers, electrocardiograph.

Acibadem Sistina Hospital has a Department of Pediatric Cardiac Surgery composed of an experienced team of 15 professors, doctors and nurses who are trained in the field of pediatric cardiac surgery. The team includes Dr. Vladimir Chadikovski, who is the only licensed pediatric cardiac surgeon in the country, as well as several other cardiac surgeons, cardiologists, anesthesiologists, perfusionists and pediatricians.

In cooperation with our doctors, a team of doctors will come from Turkey and will be available every week in the country. The aim is to reproduce the successful experience of the Acibadem hospitals in Istanbul with pediatric cardiac surgery. These centers have performed more than 15,000 operations so far.

The team will be in charge of cardiac interventions in children aged 0-18, and Acibadem Sistina aims to become a reference center for the treatment of congenital heart diseases in children in the coming period, not only in Macedonia but in the entire Balkans. All cardiac surgery services are covered by the Macedonian Health Insurance Fund.

Cardiac Surgeries in Pediatric Patients

• Absent pulmonary valve repair
• Anomalous pulmonary venous return repair (partial)
• Anomalous pulmonary venous return repair (total)
• Aortic stenosis (Ross procedure)
• Aortopulmonary window repair
• Arterial switch operation (Jatene)
• Atrial septal defect repair (total)
• Atrial septal defect repair (partial, Primum ASD)
• Bidirectional Glenn shunt
• B-T shunt procedure
• Aortic coarctation repair
• Palliation of double inlet left ventricle (PA banding, B-T shunt, Glenn, Hemi Fontan, Fontan)
• Double outlet right ventricle repair
• Ebstein’s anomaly repair
• Fontan procedure
• Hemi-Fontan procedure
• Hypoplastic left heart repair (Norwood procedure, Sano modification of Norwood, Glenn, Hemi-Fontan, Fontan)
• Interrupted aortic arch repair
• Konno procedure
• Mitral valve repair
• Norwood procedure
• Ligation of persistent ductus arteriosus
• Pulmonary artery banding
• Pulmonary stenosis repair
• Rastelli procedure
• Senning procedure
• Complete repair of tetralogy of Fallot
• Transposition of great vessels repair
• Tricuspid atresia repair (PA banding, B-T shunt, Bi-directional Glenn, Heni Fontan procedure)
• Truncus arteriosus repair
• Vascular ring repair (Double aortic arch, Right aortic arch with left sided patient)
• Ventricular septal defect repair

Pediatric Electrophysiology

Procedures

• Transvenous insertion of permanent cardiac pacemakers, single-chamber pacemaker (VVIR), double-chamber pacemaker (DDDR), cardiac resynchronization therapy pacemaker (CRT-P), cardiac resynchronization therapy defibrillator (CDR-D), single-chamber and dual-chamber defibrillation pacing systems (ICD VR, DR)
• Temporary transvenous pacing system insertion
• Invasive electrophysiological testing for atrial and ventricular arrhythmias
• Electrophysiological pharmacological testing for atrial and ventricular arrhythmias
• Electrophysiology study with radiofrequency catheter ablation for atrial reentrant tachycardia, preexcitation reentrant tachycardia
• Complete follow-up of outpatients with pacing systems
• Non-invasive outpatient heart rhythm monitoring (continuous 24-hour Holter monitoring)

Cardiac catheterization

Cardiac catheterization is a minimally invasive procedure performed by interventional pediatric cardiologists in order to gain better insight into the heart and to treat cardiac problems, including congenital heart defects.

Conditions treated by cardiac catheterization

• Aortic valve stenosis
• Atrial septal defect (ASD)
• Coarctation of the aorta
• Persistent ductus arteriosus (PDA)
• Pulmonary regurgitation
• Pulmonary valve stenosis