The Department of the Cardiology and Cardiac Surgery of the University of Debrecen Clinical Centre is responsible for the cardiac surgery care of 2.5 million inhabitants of the counties of Hajdú-Bihar, Szabolcs-Szatmár-Bereg, Borsod-Abaúj-Zemplén and the eastern part of the counties of Heves and Jász-Nagykun-Szolnok. This accounts for more than one fifth of the country's population, making the Debrecen cardiac surgery centre the largest of its kind in Hungary. The preoperative examination of patients is carried out by the invasive cardiology centres of these counties. The activities of our institute cover the entire spectrum of adult cardiac surgery, with the exception of heart transplantation and artificial heart implantation. Approximately 950-1000 open heart operations and 400-450 other procedures are performed in the clinic yearly. In recent years, the number of open heart operations performed at our centres has been the highest among Hungarian cardiac surgery centres. In addition to our obligation to provide health care, our clininc is also chosen by patients from outside the country for heart surgery.
Patients undergoing surgery in three cardiac surgeries are treated on 62 beds in the cardiac surgery nursing unit and 12 beds in the intensive care unit.
In addition to in-patient care, the clinic also offers cardiac surgery and physiotherapy.
In recent years, several new procedures have been introduced in the cardiac surgery department in Debrecen. Special mention should be made of the expansion of the types of valve sparing procedures allowing the ion of abnormal mitral and aortic heart valves. For example, in the case of aortic valve insufficiency caused by dilatation of the aortic root, the patient's own aortic valve can be retained by being implanted in a vascular prosthesis (aortic valve reimplantation). We were the first to use several new procedures in Hungary for the treatment of aortic dissection. We implant the largest number of sutureless implantable aortic valves. In 2013, in close collaboration with our cardiology colleagues, we performed the first successful catheter-based aortic valve implantations, which now exceed 150 such procedures per year. Extralorporal membrane oxygenation therapy (ECMO) has been introduced for the treatment of postcardiotomy circulatory failure refractory to medical therapy with drugs after heart surgery and for the treatment of heart failure caused by acute myocarditis.
The age of patients undergoing heart surgery increases from year to year, and serious co-morbidities are becoming more common. However, mortality has remained largely stable and has even fallen in recent years, as a result of increased attention paid to myocardial protection and monitoring brain function during surgery. To this end, new procedures have been introduced, such as the use of blood cardioplegia, flooding the operating field with carbon dioxide to prevent air embolisms when opening the heart cavities, or continuous measurement of the oxygen supply to brain tissue using near infrared spectroscopy (NIRS).
Rehabilitation activities following cardiac surgery, which were already of a high standard earlier, too, have expanded in recent years. The clinic's outpatient rehabilitation programme is now nationally renowned.
Our clinic places great emphasis on providing our patients with state-of-the-art care. To ensure this, we maintain close research and clinical cooperation with several clinics at our university and with several institutions abroad, such as the Institute of Pathophysiology at the Medical University of Vienna, the Christian Doppler Research Institute and the Department of Thoracic Surgery at the same university, and the Ludwig Boltzmann Institute of Experimental Cardiac Surgery at the Medical University of Vienna.