Modern cardiac surgery in Israel is an advanced high-tech branch of medicine that is developing at a rapid pace. According to the WHO, the first position in the list of leading causes of death, even in developed countries such as the United States and Germany, is still occupied by cardiovascular diseases. In Israel, due to the high level of cardiology and cardiac surgery, heart and vascular diseases have moved to the second position in this list.
In Israel, there are many large world-class cardiac centers and unique, “piece” cardiac surgeons, for example, at the Sourasky Medical Center.
Surgical treatment of heart diseases in Israel is carried out in high-tech hybrid operating rooms. The success rate for heart surgery in Israel is one of the highest in the world, regardless of age, comorbidities, and the severity of the general condition of patients.
Minimally invasive heart surgery is one of the main areas of cardiac surgery in Israel. They have already become common practice and are used in every second patient. The absence of complications and early postoperative rehabilitation in Israeli cardiac surgery clinics allows the patient to be discharged a week after the operation.
Cardiac surgery in Israel means the best cardiac surgeons in the world, the latest Israeli and American surgical methods for the treatment of cardiovascular diseases, and a quick recovery. At the same time, the price of operations in Israeli cardiac surgery clinics is much lower than in cardiac centers with the same advantages in the United States. Therefore, surgical treatment of the heart in Israel is in demand by patients from many countries of the world.
Heart Surgery in Israel: Benefits
Many surgeries are performed minimally invasively by cardiac surgeons. With minimally invasive interventions, Israeli cardiac surgeons perform a small, compared to open surgery, an incision in the sternum or other part of the chest. They also perform operations on a beating heart without the use of a heart-lung machine (HLM). These operations have many advantages over conventional open interventions:
- significantly reduced blood loss and surgical trauma of the chest;
- the intensity of postoperative pain is significantly reduced, it is easier for the patient to breathe and cough, there is less risk of infection and complications associated with the use of HLM;
- faster rehabilitation and return of patients to normal life;
- the better cosmetic effect after surgery.
To perform this operation, endoscopic equipment, 3D imaging system, special instruments, as well as very high qualifications, special training, and experience of cardiac surgeons are required. Therefore, these operations are put on stream only in large, well-equipped cardiac surgical centers – in Sheba and Rambam clinics.
Cardiac surgery in Israel: minimally invasive coronary artery bypass
In standard coronary artery bypass (CAB), cardiac surgeons make a 20-30 cm incision in the middle of the sternum and use HLM.
For many patients in Israel, doctors perform other options for this operation:
- OPCAB is performed without AIC through a reduced access to restore blood flow (revascularization) in several coronary arteries;
- MIDCAB is performed without AIC through a 6-8 cm incision in the sternum for the purpose of revascularization of one coronary artery.
To perform this heart operation in Israel, special devices such as stabilizers are used. They immobilize a limited area of the heart muscle at the time of bypass.
Minimally invasive valve repair and prosthetics
With congenital and acquired defects of the mitral valve, minimally invasive interventions are widely practiced in Israel:
- operations under the visual control of a cardiac surgeon;
- endoscopic interventions;
- robotic operations.
With all these operations, the incision in the sternum or chest, which is made to access the heart, is only 4-8 cm. During the intervention, the surgeon can correct the valve in case of stenosis/insufficiency, or replace the valve with a mechanical or biological prosthesis. The same heart operations in Israel are performed on selected patients with aortic defects and tricuspid valve pathology.
Robotic cardiac surgery in Israel
The most minimally invasive operations are performed using robotic technology – the Da Vinci installation. Surgeon-robot controlled by a cardiac surgeon using a computerized system:
- performs coronary artery bypass grafting of one or two arteries through a small incision in the sternum;
- performs plastic surgery or prosthetics of the mitral valve through a 4-cm incision in the intercostal space;
- removes heart tumors;
- installs a pacemaker and a cardioverter defibrillator.
The success rate for these heart surgeries in Israel is 98-99%. Patients after cardiac surgery with the help of Da Vinci recover very quickly.
Complicated surgical treatment of heart diseases in Israel
Some diseases of the heart and blood vessels are successfully treated in Israel without surgery using high-tech procedures by catheterization. But in many cases, only cardiac surgery can help, and most often both are needed. Therefore, all cardiac surgeries in Israel are performed in a hybrid operating room, equipped both as a modern operating unit and as a catheterization laboratory.
During one stay of the patient in the operating room, an Israeli cardiac surgeon can cure many diseases:
- ischemic heart disease after CABG or transmyocardial laser revascularization;
- valvular pathology by performing plastic surgery or prosthetics of the aortic, mitral, and tricuspid valves;
- aortic aneurysm, having made a prosthesis of this vessel;
- cardiac arrhythmias using the “maze” operation;
- heart failure by ventricular/atrial reconstruction.
In most cases, cardiac surgery is accompanied by other medical procedures such as stenting and balloon plastics of the coronary arteries, radiofrequency ablation of arrhythmogenic zones, the Watcnman procedure. The result of these operations is checked by a cardiac surgeon on the operating table, using diagnostic methods such as ECG, EchoEG (echocardiography), angiography, EPE (electrophysiological examination).
Cardiac surgery in Israel: “maze” operation for the treatment of arrhythmia
This is a complex operation with an increased risk of complications, performed mainly on patients who need other procedures. The purpose of the “maze” is to restore the sinus rhythm of the heart. To do this, the cardiac surgeon creates a “maze” of micro-incisions in the atrial myocardium. The labyrinth of scars formed at the site “does not let” impulses along the pathological pathways in the atria and thereby prevents their fibrillation.
Modified versions of the “maze” are also carried out in Israel:
- using radiofrequency ablation to create a “maze” on the surface of the atria (instead of a scalpel, the surgeon uses an electrode);
- using cryoablation to isolate the atria from pathological impulses (freezing and damage to myocardial cells are performed, in place of which a “maze” of fibrous tissue appears);
- without opening the chest through several punctures in the intercostal spaces (in some patients who do not need other types of cardiac surgery).
The effectiveness of the “maze” in Israel: the absence of atrial fibrillation in patients for 15 years reaches 95-98%. Restoring a normal rhythm in patients after surgery completely eliminates the risk of cardiac arrest and stroke. Three months later, after the final formation of the “labyrinth”, after the examination, drug therapy is canceled.
Surgical Treatment of Aortic Aneurysm in Israel
In Israel, since the 90s of the last century, all types of operations for aortic aneurysms have been performed. Their result is almost guaranteed: the success rate is 85-90%, according to Israeli clinics. Interventions are also carried out in elderly patients (after 75-80 years) with the same indicators.
Open surgery is performed under conditions of hypothermia – reduced body temperature and using HLM. Small aneurysms are cut off from circulation with a clip. The area of the aorta with a large aneurysm is replaced with an endoprosthesis made of biocompatible materials. If the surgeon replaces the aortic root, then he uses a special technique that allows to save the patient’s own aortic valve.
Pediatric Cardiac Surgery in Israel
The achievements of pediatric cardiac surgery in Israel are also known throughout the world. Cardiac surgery is performed in specialized departments within large university medical centers (MCs). Among them:
- Safra Children’s Hospital at Sheba Medical Center;
- Institute of Cardiology at Schneider Hospital;
- Department of Pediatric Cardiology of the Cardiology Center at Sourasky Medical Center;
- Children’s cardiology department of Assuta Clinic;
- Department of Pediatric Cardiology, Hadassah Medical Center.
The main direction of pediatric cardiac surgery is the correction of congenital malformations of the heart and blood vessels. Many of them are detected by ultrasound during fetal development. Cardiac surgeons perform the most complex heart surgeries in the first days of life, operate on premature babies, starting from a weight of 1 kg 400 g, and perform vascular surgeries on newborns with any weight. About 40% of all operations on the heart and blood vessels in children in Israel are performed under the age of one year.
Israeli pediatric cardiac surgeons correct:
- defects of the interatrial interventricular septum;
- Fallot’s tetrad;
- stenosis of the pulmonary artery;
- coarctation of the aorta, open ductus arteriosus, aortic and subaortic stenosis, aortopulmonary window;
- transposition of the main vessels;
- anomalies of the coronary arteries, coronary fistulas;
- various heart valve defects;
- double discharge of the right ventricle;
- hypoplasia of the left parts of the heart;
- abnormal pulmonary venous return/pulmonary venous stenosis, vascular rings, and other malformations of the cardiovascular system.
Many operations, as in adult patients, are performed by surgeons using minimally invasive techniques. An interdisciplinary approach is practiced, taking into account comorbidity and the needs of each child. With all the advantages, the price of cardiac surgery in Israel in pediatric clinics is usually less than in pediatric cardiology centers in Germany and the USA.
Heart Transplantation in Israel
The first donor heart transplantation operation in Israel is performed in 1968. In 2012, a fully artificial heart is implanted in an adult patient, and in 2019 – in a child. Cardiac surgeons install a high-tech artificial heart to the patient temporarily, while waiting for a donor organ. Israel has accumulated successful experience in heart transplantation for adults and children. In the presence of a donor’s heart, organ transplantations can be performed with good long-term results by cardiac surgeons at several medical centers in Israel, such as the Beilison Medical Center and the Hadassah Medical Center.
Cardiac Surgery in Israel: Early Rehabilitation After Surgery
Cardiac surgery in Israel is characterized by early postoperative rehabilitation. An interdisciplinary team of specialists “puts patients on their feet” after surgery of any complexity within 7 days. Therefore, most patients are discharged home after surgical treatment of the heart in Israel in two weeks.
How to choose a cardio center and a surgeon in Israel
To choose a cardiac surgeon and a place for heart surgery in Israel, it is advisable to contact Experts Medical specialists. They have all the necessary information and experience in organizing this treatment. Doctors-coordinators will help organize a consultation in several cardio centers and choose the most suitable option for the cost and other important criteria. They will also take care of the trip management and comprehensive support during cardiac surgery in Israel.
The material was checked and approved by Erica Igonina, a medical author at Experts Medical.
Sources:
