Cardiac surgery in Belgium. State of the art in 2003.

Cardiac surgery in Belgium has reached since many years a high quality level and improves continuously. In mitral valve surgery, repair of the valve has been substituted to its replacement. Repair is now the standard operation for degenerative pathology. Long-term results are well established and indications standardised. In aortic valve surgery, prolapse of a leaflet, dilatation of the sinotubular junction, aneurysm of the sinus of Valsalva are now repaired with very good results. When the valve is unrepairable, a wide choice of available homograft, stentless valve or aortic root allows the most adequate operation. In coronary artery bypass graft (CABG), arterial grafts are increasingly used over the least years because of their higher long-term patency rates. Off-pump coronary bypass, that is CABG on the beating heart, is more and more frequently performed from 2.4% in 1998 to 17.9% of the cases in 2000. The development of mechanical circulatory support, also called "artificial heart" is encouraging but still far from perfect. During the 2 last years, 31 devices were implanted in Belgium. Twenty patients were either successfully transplanted or weaned from the pump and returned to their home. Cardiac surgery in Belgium is still developing and remains of high quality thanks to the continuous introduction of new therapeutic approaches and to the close collaboration between intensivists, anaesthesiologists, perfusionists and cardiologists. As a result, patients benefit today from the best therapeutic modalities.