OVER 40 YEARS IN CARDIOSURGERY

 

NOVOSIBIRSK RESEARCH INSTITUTE OF BLOOD CIRCULATION PATHOLOGY

THE LEADING MEDICAL INSTITUTION IN THE ASIAN PART OF RUSSIA

 

15, Rechkunovskaya, Novosibirsk, Russia, 630055

Telephone: 7+3832+324758

Fax: 7+3832+324550

by

Professor Alexander M. Karaskov

 

MAIN ACTIVITIES

 

Novosibirsk Research Institute of Circulation Pathology is an integrated cardio surgical and cardiological centre destined for treating patients all over a vast area of the Asian part of Russia. Over a period of 42 years Novosibirsk Research Institute of Circulation Pathology, being under federal jurisdiction, has rendered qualified assistance to more than 200,000 patients, 48,000 of which underwent a heart operation.

 

The Institute is involved in developing the scientific principles of cardio surgical assistance to population, the methods of treatment and prophylaxis of cardiovascular diseases in children and adults. The major line of research being done at the Institute is pathology of circulation and concomitant processes observed in patients with various defects of the cardiovascular system, especially heart diseases (both congenital and acquired), ischemic heart disease, complications of these diseases, as well as their conjunction with diseases of other organs and systems. Great emphasis is also placed on surgical correction and intensive postoperative rehabilitation. Particular attention in scientific investigations is given to thorough study of general circulation pathology dynamics, phased development of heart diseases, development of adaptation, compensation and paracompensation processes in the circulation system. Our cardio surgeons have a unique chance to directly study a heart, particularly in the course of operations, while the cardio surgical clinic of Novosibirsk Research Institute of Circulation Pathology has become the centre of heart physiology/pathology study. Our researchers have received 78 author's certificates, prepared 27 monographs and 49 collections of scholarly Works. To treat ischemic heart disease, stenocardia, myocardial infarction and septic states, such unique methods as perfusionless hypothermia and intravenous application of a laser beam have been developed and reduced to practice.

 

Novosibirsk Research Institute of Circulation Pathology has also become the centre of scientific activities related to cardiology and cardio surgery all over the huge territory from the Urals to the Far East: It is here that the scientific societies hold their conferences, meetings and workshops. Over 8000 cardio surgeons, cardiologists and anaesthesiologists have been trained for the Institute and other clinics. Numerous refresher courses are being conducted for physicians and teachers of medical institutes. The Institute activities are widely covered abroad. Specialists from Australia, Austria, England, Germany, the Netherlands, Israel, India, Italy, Canada, China, Mongolia, France, Czech Republic, Yugoslavia and Japan visit our institute frequently to adopt our methods.

 

HISTORY

 

The Institute was established in 1957 as the Research Institute of Experimental Biology and Medicine. It was founded by Professor of Medicine Y.N. Meshalkin - the pioneer of the Soviet cardio surgery. Professor Meshalkin (Academician of the Russian Academy of Medcical Sciences) was in charge of the Institute until 1990. He was the first to carry out a cavapulmonal shunt when operating on a patient with Fallot's tetrad (1956), to re-implant one lung and later both lungs in succession to a patient with bronchial asthma (1962), to substantiate and use the method of intravenous laser radiation on patients with ischemic heart disease (1979). Starting from 1959 he would operate regularly on a «dry» heart under moderate hypothermia (28-30 degrees Celsius) of patients with congenital and acquired heart deficiencies.

 

Since 1990 the Institute has been run by Professor E.E. Litasova, Corresponding Member of the Russian Academy of Medical Sciences, Academician of the Russian Academy of Natural Sciences, member of three international surgical societies.

 

Professor E.E. Litasova is the founder and manager of a unique school of cardio surgery and the author of a new method developed to carry out sophisticated reconstructive heart surgery under perfusionless hypothermia. The essence of this method is that heart surgery is performed under the conditions of deep (without assisted circulation) hypothermic protection: outer cooling down to 23 - 25 degrees Celsius by means of either natural or artificial ice and simultaneous treatment with the medicaments protecting the organism against detrimental effect of the cold itself. This allowed for the first time in the world's practice to withdraw a heart from circulation during the operation for a period of 75-90 minutes, thus providing efficient treatment of 75-80 % of patients with heart diseases.

 

For over 40 years the Institute employees have been working continually on the improvement of surgery technologies enabling to radically cure practically all cardiovascular system diseases.

 

INSTITUTE CLINIC STAFF

 

There are about 850 specialists working at the Institute now: professors, doctors, candidates, researchers, physicians, nurses, engineers, technicians, etc. The Institute has a surgical building for 410 beds, 12 operative rooms, postoperative and recovery wards for 37 beds, laboratories (X-ray, heart catheterization & contrasting, functional diagnosis, biochemical, immunological, circulation & respiration physiology, pathomorphology & electronic microscopy), computing centre, its own donor station, experimental building and so on. The Institute is well furnished with modern equipment and facilities. There is also a boarding house/hotel for patients and their relatives.

 

OPERATIONS AND TREATMENT RESULTS

 

Various operations on patients with rare and complex congenital heart diseases, including «blue» and «pale» ones, are being done at the Institute, the age of patients varying from a few weeks to over 50. Multi-valve prosthetics is widely used for patients with acquired heart diseases, while those in need of valve replacement are offered aortocoronary shunting. Coronary arteries bypass surgery, coronary plasty, myocardium tunnelling and a number of other modifications undertaken in the case of a failure to carry out direct revasculation of myocardium find extensive application in those patients who underwent myocardial infarction or ischemic infarct complications.

 

Every year over 3500 patients are treated at the Institute clinic, with 1100 of them undergoing heart surgery. The 1998 surgical turnover has amounted to US$4,500,000.

 

More than 560 operations per year on patients with congenital heart pathologies are performed, with the death rate within 0 to 3.5 %. Simple congenital heart pathologies make up 28 %, while complex multi-component ones are equal to 72 %. About 250 acquired heart pathologies are cured every year, with the death rate 1.5 to 4.5%. It is worthwhile noting that 95 % of patients are operated with a high degree of risk due to disease stage.

 

More than 500 operations on patents with ischemic heart disease are performed annually, with the death rate 0.9+3.5% and 86 % of operations falling in the high-risk category. The Institute clinic carries out active medical observation of the patients operated. 80 % of those with congenital heart pathologies show good results at a later phase of observation, 17 % satisfactory and 3 % - unsatisfactory results. Correction of acquired heart pathologies yields 47 % of good results, 44 % of satisfactory and 9 % of unsatisfactory results. Surgical intervention in the case of patients with ischemic heart disease and its complications results in 17 % of good, 69 % of satisfactory and 14 % of unsatisfactory outcomes.

 

To efficiently treat the patients identified as having heart diseases, the Institute is working closely with the authorities and medical institutions of the regions.

 

ROLE OF NOVOSIBIRSK RESEARCH INSTITUTE OF CIRCULATION PATHOLOGY IN CARDIOLOGICAL PATIENTS CURE

 

The Institute clinic patients come from a vast territory extending from the Urals to the Far East with population over 53 million people. For the most part our patients are residents of Western Siberia (about 50 %), a considerable share of them live in Eastern Siberia (19 %) and the Far East (17 %). The inhabitants from Middle Asia, Kazakhstan and European part of Russia are also treated at the Institute.

The Institute's share in the total amount of all operated patients in Siberia runs close to 51 % (patients with congenital heart diseases) and 37 % of patients with acquired heart diseases, with a higher percentage of sophisticated operations. Our institution is the largest cardiological clinic behind the Urals - is has one third of all beds belonging to 10 cardiological centres which are found on this territory.

 

TREATMENT NEEDS

 

The needs of population of the Eastern part of Russia in heart surgery to be performed according to WHO standards are estimated to be 37,000 operations per year. For example, the death rate due to circulation-related diseases for men residing in the Eastern part of Russia varies in different regions from 46 % to 61 % against those dying a natural death. In the context of an economic crisis in Russia and a decline in living standards of the population these indicators tend to deteriorate, thus making heart surgery a problem of today.

 

At present the potential of our clinic permits increasing the number of patients treated by 3 times and performing 3,000 - 4,000 operations per year depending on the diagnosis. The surgical wards having been re-equipped, we are now able to do any sophisticated heart surgery. The leading world cardio surgeons who happened to carry out demonstrative heart surgery at our Institute gave high praise to the clinic equipment and our surgeons and staff's skills.