Gottsegen Hungarian Institute of Cardiology

Modern cardiology was born during the period of World War II, when the first heart operations were performed in the United States, Sweden and England and heart catheterization became a routine clinical procedure. There was only one specialist in Hungarian internal medicine, György Gottsegen, who recognized the advent of a new world in cardiology, realizing that without invasive diagnostics, modern cardiology could no longer exist. He was the founder of the Hungarian Institute of Cardiology in 1957 which was become the only centre in Hungary dedicated exclusively to cardiology. The clinical and scientific prestige of the Institute grew rapidly in Hungary and abroad necessitating a modern, more spacious building. In 1977, the Hungarian Institute of Cardiology moved to a modern new building which was already able to host the entire field of non-invasive and invasive cardiology, adult and pediatric cardiology and heart surgery as the largest cardiology centre in Hungary. The Department of Adult Cardiology of the Institute became the Department of Cardiology of the Semmelweis University.

In the next decade, pediatric cardiology in Hungary experienced a tremendous progress and could no longer function on the 3rd floor of the Hungarian Institute of Cardiology building. It could not meet the increased requirements, waiting lists for catheter therapy or heart surgery were very long. Setting up a modern pediatric cardiology centre of rather larger capacity became a justified necessity. In 2000, the new state-of-the-art Pediatric Centre of the Hungarian Institute of Cardiology was opened. As an individual budgetary organization, the Hungarian Institute of Cardiology is functioning under the control of the Ministry of Health and covers the entire spectrum of pediatric and adult cardiology.

The Gottsegen Hungarian Institute of Cardiology was founded to be one of the leading cardiology centers in Hungary as the background institution of the Ministry of Health. It provides a first-class service in cardiology patient care, scientific research, medical education and medical data collection. It covers the entire field of pediatric and adult cardiology performing the most comprehensive and expensive treatment modalities in Hungary as the only centre, such as interventional pediatric cardiology, pediatric heart surgery, pediatric and adult heart transplantation and ventricular assist device therapy, adult non-coronary catheter interventions (closure of intracardiac communications and valvular interventions), adult congenital heart disease therapy. The faculty is young and dynamic, and was trained in the leading cardiology centers of Europe, North America and Australia. 

The Gottsegen Hungarian Institute of Cardiology is committed to providing excellence in multidisciplinary, comprehensive, and innovative cardiovascular care. A dedicated team of adult and pediatric cardiologists, cardiac surgeons, cardiac anesthesiologists, and cardiac nurses has been assembled to provide the very best in cardiology. The Gottsegen Hungarian Institute of Cardiology’s commitment to education is one of the dimensions that sets it apart from other major centers. Postdoctoral and allied training programs, seminars, symposia, conferences, publication of scientific and clinical findings, training materials, and public outreach are all part of the Institute’s educational thrust.

Head: Péter Andréka, MD, PhD

With 145 licensed beds, this department is the largest cardiology department in Hungary. It is functioning on three floors with hundred hotel beds in 2-5-bed wards, with 35 urgent care beds and with 10 cardiology intensive care beds. The nursing stuff is highly trained and very much devoted to its profession.

With 7.800 in-patient and 50.000 out-patient treatments in each year, the department is the busiest tertiary referral centre in Hungary. We also offer a popular residency and fellowship program in internal medicine and cardiology.

The Department of Adult Cardiology admits patients from the entire field of cardiology and gets referrals from both the Budapest region and from the entire country and the neighboring counties respectively as a tertiary referral centre.

The imaging laboratory of the Department is equipped with state-of-the-art echocardiography machines (HP-Phillips 5500, Phillips ie33, GE Vivid-i) and 16.000 examinations are performed yearly. Our echocardiography laboratory has always been at the forefront of echocardiography in Hungary. Our primary goal is to provide superior noninvasive echocardiography imaging and clinical interpretation for patient care. Our laboratory serves as an all-inclusive clinical, teaching, and research facility. We offer the full range of standardized and newer echocardiography techniques (TTE, TE, TDI, CRT optimization, dobutamine stress echo, stress test echo, contrast echo). Vascular, stress test and Holter laboratories are also very busy. The Department has launched the Ventricular Assist Device Program (Impella, Berlin Heart) in Hungary and our next goal is to perform transcatheter aortic valve implantations routinely.

Our Cardiac Intensive Care Unit (CICU) offers expert care for the most critically ill cardiac patients. In this ten-bed unit, we treat complex cardiac conditions including:

·  acute coronary syndromes,

·  cardiogenic shock ,

·  acute aortic syndromes,

·  end-stage congestive heart failure and cardiomyopathy, including patients awaiting cardiac transplantation,

·  complicated supraventricular and ventricular arrhythmias and heart block,

·  congenital heart disease complications in adults,

·  pulmonary hypertension,

·  respiratory failure. 

Our highly skilled team of medical professionals has extensive experience in managing some of the most high risk and seriously ill cardiac patients. Attending physicians, cardiology fellows, residents, physician assistants, and medical house staff, along with specialty-trained cardiac nurses with critical care expertise, provide round-the-clock care using the most sophisticated procedures available: hemodynamic monitoring, ventilation therapy, hemodialysis, intraaortic balloon counter pulsation, left ventricular assist device therapy (Impella Recover). Last year 1.500 seriously ill patients were admitted to the CICU from the entire country and this number is constantly increasing. We participate in the primary PCI rotational on-call system in the Budapest region.

This is a 35 bed-unit with 12 telemetry beds dedicated to treat patients discharged from the CICU, awaiting for ICD, living with Berlin Heart VAD or with the necessity for monitoring in any reason. The majority of the urgent referrals from other hospitals go through this Unit.

The Department of Adult Cardiology is the top referral centre for severe heart failure in Hungary. The most seriously ill are treated as in-patients, but the main goal of our heart failure program is helping people live quality lives through outpatient management of their heart failure. The program is managed by attending physicians, registered nurses, physiotherapists, dietetics, psychologists and social workers.

The specialized team of the Unit offers the most recent and promising array of treatment options available. Among these are proven state-of-the-art medications, mechanical heart assist devices, and surgical interventions including resynchronization therapy and transplantation.

The Department of Adult Cardiology is the leading centre selecting transplant candidates in Hungary and all patients awaiting for urgent transplant or with the necessity for circulatory support are admitted to the Department from the entire country. The team of the Heart Failure and Transplant Unit looks after all the heart transplanted patients (82 patients as of June 2008) in the country and deals with the problems of the post transplant period.

The success of cardiac surgery in childhood at the Gottsegen Hungarian Institute of Cardiology has produced a large population of adults with congenital heart disease. These adults present a unique challenge for the cardiology community. In Hungary, ours is the only adult congenital heart disease program. Our cardiologists familiar with particular anatomy and problems provide highly specialized in- and out-patient care of adults with congenital heart disease looking after some 2.500 patients. Our program includes physicians specifically trained in adult congenital heart disease with expertise in echocardiography, interventional cardiac catheterization, interventional electrophysiology, pulmonary hypertension, complex congenital heart surgery, and cardiac transplantation. Related care by specialists in high-risk pregnancy, genetics, fetal echocardiography, GI and liver disease, pulmonary, and hematology is readily available.

Head: Géza Fontos, MD

In two (by September already three) cardiac catheterization laboratories we offer the most complex interventional cardiology service in Hungary. Non-coronary cardiac interventions are performed exclusively at our Department of Interventional Cardiology in Hungary, including adult congenital cases, ASD/PFO closures, mitral, pulmonary and aortic balloon valvuloplasties, closure of post infarct ventricular septum ruptures. The cardiac catheterization laboratories are equipped with mono- and biplane Siemens machines and with sterile air-conditioning system. The third ready-to-install cardiac catheterization laboratory is designed to function as a semi-hybrid OR. 

Approximately 4.300 invasive procedures were performed yearly in the two catheterization laboratories, including 1.500 PCI-s, 100 ASD closures, 30 PFO closures, 50 valvuloplasties and 120 endomyocardial biopsies but with three catheterization laboratories, these numbers are expected to increase. Last year 700 PCI-s were performed in myocardial infarction as primary, rescue or post thrombolysis PCI-s. 

Head: Csaba Földesi, MD

The Department of Electrophysiology and Pacing has a long tradition of providing effective and comprehensive care for patients with arrhythmias. A wide range of diagnostic and treatment services is offered, including device implant (PM/ICD) and catheter ablation for arrhythmias including atrial fibrillation and ventricular tachycardia. The Department of Electrophysiology and Pacing is the busiest high volume center in Hungary with over 400 catheter ablation procedures per year for atrial fibrillation and all types of supraventricular and ventricular arrhythmias. The staff physicians of the Department of Electrophysiology and Pacing have a longstanding experience in device implantation, including PMs, ICDs and they work closely with the physicians of the Heart Transplant and Heart Failure Unit for the treatment of heart failure with biventricular pacing.

Head: László Székely, MD, PhD

Performing over 1.000 open-heart procedures a year in three ORs, the Department of Adult Heart Surgery is the busiest in the country. In addition to on- and off-pump coronary bypass surgeries (90% off-pump), we perform a high volume of valve procedures, including mitral valve repair (35% of all mitral valve surgeries). Our surgeons undertake some of the most complex and challenging cases,  such as combined bypass and valve repair or replacement procedures. Approximately 700 CABG-s and 300 valve procedures are performed in a year. The mortality rate for CABG was 2.35% in 2007, and for aortic valve replacement (147 cases in 2007) was 2.04%. The overall mortality rate at the Department is 4.1%. The Department has a significant amount of experience in endocarditis surgery due to our very good collaboration with the Szent László Hospital for Infectious Diseases. 

Head: András Szatmári, MD, PhD

Pediatric cardiology and pediatric heart surgery is very well centralized in Hungary and covers almost the whole population of the country. Our Centre for Pediatric Cardiology is the only centre in Hungary providing specialized care for patients with the most complex problems of pediatric cardiology.

With 1.100 in-patient and 7.800 out-patient treatments in each year, the department is among the busiest European centers with a very low overall mortality rate of 3.2%. In 2007, 500 pediatric diagnostic catheter procedures and 230 catheter interventions were performed at the Centre with 100 ASD occlusions, 20 PFO occlusions, 3 VSD occlusions, 31 ductus Botall occlusions, 13 other communication occlusions, 41 valvuloplasties and 8 Rashkind septostomies. In 2007, 526 pediatric heart surgeries were performed including the most complex congenital cases. In 2007, the first Hungarian pediatric heart transplantation was performed in an 8-year-old boy, and in a 9-month-old girl in 2008 with success. The pediatric ventricular assist device program is the part of the ventricular assist device program of the Institute.