The Department is structured into two distinct, yet closely related sectors: Cardiac Surgery and Thoracic Surgery. They are served by the same dedicated theatre complex and ICU ward.
In September 30, 2002 the Department moved into new facilities. A new building, independent from but connected to the central hospital complex was planned exclusively for this purpose. These facilities, with a total area of approximately 7,000 m2, are distributed by three floors. The top floor houses the administration and academic facilities; the theatre complex, the ICU and intermediate care ward and the transplantation unit are situated in the intermediate floor; and the lower floor houses the cardiac and thoracic surgery ward and the outpatient and day-care areas. An X-Ray laboratory is also located here. This cinclude a cath lab where myocardial biopsies are performed.
The operating theatre complex has four dedicated operating theatres, with hemodynamic monitoring and recording systems, open-heart surgery equipment, centrifugal pumps, intra-aortic balloon pumps and an echocardiograph for intraoperative trans-esophageal ultrasound, which is used routinely in valve surgery and, when necessary, in other types of surgery. All theatres are equipped with video-camera, with both U-Matic and VHS recording systems, which also allows for long-distance cable transmission.
The complex includes an area for pre-anesthetic preparation of the patients, storage facilities and a complete sterilization unit.
Intensive Care Unit
The ICU is an open area facility with 9 beds, each with invasive and non-invasive monitoring and ventilation. There is also an isolation unit.
All the monitors in the Department are connected to a dedicated and structured network and can be accessed from anywhere in the facilities and, through the internet, from anywhere else. Ventilator and fluid management data may also be integrated.
On average, patients remain in the Intensive Care Unit under 24 hours and from here they are transferred to the Intermediate Care Unitard. In this unit there is one nurse per patient in every shift. A member of the surgical team assists the patients on permanent duty.
Intermediate Care Ward
This Unit has 18 beds, including 4 or 5 pediatric cots and 6 beds dedicated to transplantation. All beds are equipped with fixed monitors and movable ventilators can also be used. Two of the transplantation-dedicated beds are isolated and equipped as ICU beds. Children are kept in the pediatric area throughout their hospital stay. Adults remain in the intermediate care 2 days on average.
The admission ward has 38 beds. It includes a postoperative recovery unit with 4 fully-monitored beds. The ward has a telemetry system for ambulatory control of the ECG and, when necessary, O2 saturation. There is a room for wound-dressing and small surgery. In most cases, patients remain in the Department from 6 to 8 days following surgery.
An outpatient area includes 4 consultation rooms and an examination/dressing room. There is also a Cardiology room, equipped for echocardiography and electrocardiography. The Departement has 3 ecocardiographs, including one equiped for TEE. There is also a Gymnasium for use by the patients and, after hours, by the staff.
This facility houses a room for tele-radiography of the thorax, equipped with a Philips Practix 300 mobile X-Ray Unit, and a catheterization laboratory, equiped with a Philips Pulsera mobile C-arch and appropriate hemodynamic capability. Both machines can be used anywhere in the premises.
All of the Department’s doctors work full-time (12 hours/day on average) and exclusively for the Department. Besides, the Residents and Staff-surgeons work rotating night and weekend shifts, with the permanent support of one of the Chiefs of Service and of the Department’s Director.
All work is carried out as a team; all doctors are responsible for all patients, in all sectors of the Department, and may intervene in the remaining Hospital Departments when asked to do so. The team includes one full-time cardiologist and two anesthetists who work exclusively for the Department.
Medical visits to the wards are carried out twice daily and once to the patients to be operated on the following day.
Clinical cases are presented and discussed every week with the Departments of Cardiology (Wednesday, 3pm), Pediatric Cardiology (Tuesday, 4pm), and Pneumology and Pathology (Friday, 11am).
Outpatient clinics are conducted daily. Patients are usually seen once preoperatively and two weeks after leaving the hospital, and in most cases they are referred back to their cardiologists for follow-up. There are also two sessions a week for pre-operative assessment of patients from outside the center region of the Country.
The Department now performs an average of 22 cardiac and 10 thoracic surgeries a week. Often, it also carries out smaller surgeries (eg. closure of PDAs) in premature babies, in the Intensive Care Unit of the Pediatric Hospital and in Neonatology Unit in the Maternity Dr. Daniel de Matos and the emergency surgeries in the casualty Departement.
© University of Coimbra · 2009
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