Diagnosis of aortic valve stenosis

About the department

The Department of Adult and Pediatric Cardiac Surgery, Heart Transplantation, Vascular Surgery at the Baskent University Hospital Istanbul offers the full range of surgical interventions for the treatment of diseases of the cardiovascular system, including donor and artificial heart transplantation. The department's priority clinical focuses include coronary artery bypass grafting, heart valve surgery, thoracic aortic surgery, heart transplantation, as well as the treatment of diseases of the blood vessels, arteries and veins. The department also provides treatment to children with congenital heart diseases. The medical facility has an excellent technical base for performing high-complexity surgery in order to restore the normal functioning of the heart. Whenever possible, the doctors use sparing minimally invasive techniques, which ensure a short hospital stay after surgery. The skills and professionalism of the department's cardiac surgeons are known far beyond Turkey. They have performed over 126 heart transplantations and thousands of successful heart surgical procedures that have saved the lives of many patients from Turkey and abroad.

The Head Physician of the department is Prof. Dr. med. Deniz Suha Kucukaksu. The specialist has exceptional clinical experience and regularly demonstrates the highest success rates in the surgical treatment of cardiac pathologies. He underwent training in leading medical centers in the developed countries of Europe and the USA, and is a member of many international societies for cardiac surgery and heart transplantation. In addition, the doctor has prestigious research awards.

The department is one of the few medical facilities in Turkey where one can undergo donor heart and artificial heart transplant surgery. These interventions are among the high-complexity surgical procedures, and therefore they can be performed only in the most progressive hospitals in the world. The most common indications for heart transplantation are pathologies such as inoperable heart defects and heart tumors, end-stage or severe heart failure, coronary heart disease, myocardiodystrophy, severe cardiomyopathy, and others. Since the search for a donor heart takes quite a long time, the department's cardiac surgeons are increasingly resorting to an artificial heart implantation. In addition, an artificial heart transplant is indicated for patients who have contraindications for donor organ transplantation (for example, insulin-dependent diabetes mellitus). Prior to the appointment of the heart transplant operation, the patient undergoes a number of diagnostic tests, thanks to which the doctors can determine as accurately as possible the degree of the body readiness for surgery. These include a CT scan of the chest, electrocardiography and echocardiography, biochemical profile, Holter monitoring, and heart catheterization. If the diagnostic results are satisfactory, the attending physician decides to perform the heart transplantation. The department uses two modern artificial heart systems – a left ventricular assist device (LVAD) and a Total Artificial Heart system. Both donor or artificial heart transplantation ensures a high quality of life for the patient without any serious restrictions.

The department's team of doctors quite often admits patients with heart valve diseases for treatment. The most popular interventions in this area include reconstructive surgery on the aortic and mitral valves, as well as operations to replace these valves. Heart valve replacement is indicated for patients suffering from heart valve stenosis or insufficiency, which cause blood flow disturbances, which in turn leads to various cardiac pathologies. The department uses both mechanical and biological prostheses to replace heart valves. The main advantage of a mechanical valve is its unlimited service life, while valves made of biomaterial have to be reimplanted every 10-15 years. However, the placement of a biological artificial heart valve eliminates the need for lifelong anticoagulant therapy, which is required after the mechanical valve implantation. To perform heart valve replacement surgery, the department's cardiac surgeons prefer sparing minimally invasive techniques, without cardiac arrest. This approach allows them to significantly reduce the time of postoperative rehabilitation and minimize the risk of complications.

The department performs aortic valve replacement using two modern methods – transcatheter and percutaneous implantation. The department's specialists prefer the method of transcatheter aortic valve implantation (TAVI), in the course of which the valve is delivered to the heart via a catheter inserted through an artery in the groin (the femoral artery is mostly used). The new valve is implanted in place of the old one and completely replaces its functions. In this case, the intervention eliminates the need to remove the old (the patient's own) aortic valve, since the new one displaces it. Mitral valve replacement surgery is performed using both spaing laparoscopic techniques and classical open surgery.

The department's team of cardiac surgeons also specializes in coronary artery bypass grafting in patients with coronary heart disease. When performing this type of operation, the doctors set themselves the goal of creating a new bypass for blood flow outside the blocked part of the artery. The department offers all options of coronary artery bypass grafting – beating heart bypass surgery and coronary artery bypass grafting with the use of a heart-lung machine, minimally invasive coronary artery bypass grafting without opening the chest, as well as coronary artery bypass grafting using the da Vinci robotic system. Prior to the bypass surgery, the department's specialists without fail perform diagnostic coronary angiography, which allows them to assess the state of the heart vessels and their patency. A part of the patient's own artery or vein from the arms, chest or legs is used as a graft. The artery or vein for the graft formation is harvested using endoscopic techniques, which can significantly reduce the number of postoperative complications. When performing the intervention, the cardiac surgeons clamp the clogged artery with a thin elastic band to stop the blood flow. The formed graft goes from the aorta to an area below the level of the obstruction, after which blood flow to the heart is restored.

The department's key clinical focuses include:

• Donor heart transplantation
• Artificial heart transplantation
  • Left ventricular assist device (LVAD)
  • Total Artificial Heart 
• Reconstructive heart valve surgery
• Heart valve replacement (focus on aortic and mitral valve replacement surgery)
• Coronary artery bypass grafting
  • Beating heart bypass surgery
  • Bypass surgery using a heart-lung machine
  • Minimally invasive coronary artery bypass grafting without opening the chest
  • Coronary artery bypass grafting using the da Vinci robotic system
• Surgical correction of congenital heart defects in children
• Surgical treatment of diseases of the thoracic aorta
• Vascular surgery
  • Treatment of varicose veins
  • Treatment of post-thrombotic syndrome
  • Treatment of lymphedema
  • Treatment of trophic ulcers of venous etiology
  • Treatment of carotid artery diseases
  • Treatment of abdominal aortic aneurysm
• Other surgical services