Head: Professor Joško Bulum, MD, PhD, Internal Medicine Specialist, Cardiology Subspecialist
Head Nurse: Marija Matoš, bacc. med. techn.
Professor Joško Bulum, MD, PhD, Internal Medicine Specialist, Cardiology Subspecialist
Assistant Professor Kristina Marić Bešić, MD, PhD, Internal Medicine Specialist, Cardiology Subspecialist
Tomislav Krčmar, MD, PhD, Internal Medicine Specialist, Cardiology Subspecialist
Zvonimir Ostojić, MD, PhD, Cardiology Specialist
The Clinical Unit for Invasive and Interventional Cardiology was established out of the first Croatian Heart Catheterization Laboratory, which was founded at UHC Zagreb in 1952. The Clinical Unit for Invasive and Interventional Cardiology, which operates within the Department, represents a unique Unit given the spatial and technological conditions that are in line with the most modern world standards for interventional cardiology. From the very beginning, it has been included in the network of interventional treatment of acute myocardial infarction, which started systematically in the Republic of Croatia in 2004. Approximately 3,000 diagnostic cardiac catheterizations are performed annually, and more than 1,200 are percutaneous coronary interventions (PCI). All these procedures are routinely performed by transradial approach with the possibility of mobilizing patients immediately after the procedure. The most complex procedures on coronary arteries, such as rotablation and opening of the so-called chronic total occlusions (CTO) are also performed routinely.
In 2019, intravascular lithotripsy (shock wave) was used in the treatment of calcified coronary stenoses for the first time in the Republic of Croatia and it is routinely used today. Also, at the beginning of 2021, the latest device for rotational atherectomy (RotaPro) was acquired. In addition to the implantation of a wide range of intracoronary stents, when indicated, the so-called intracoronary drug-releasing balloons (DCB) are implanted.
Clinical Unit for Invasive and Interventional Cardiology works in brand new, representative space of total surface of 550 m 2, where four most modern angiography radiology devices are used. One of the procedure room is equipped for the so-called hybrid procedures involving interventional cardiologists and cardiac surgeons. This enables the performance of sophisticated procedures such as transcatheter aortic valve implantation (TAVI) and interventional procedures on the thoracic (TEVAR) and abdominal aorta (EVAR). Since the beginning of 2017. the Unit is certified for implantation of both types of percutaneous aortic valves that are today considered the gold standard (CoreValve, Evolut R, Sapien 3). Total of 200 procedures have been performed so far. All procedure rooms allow advanced imaging of coronary arteries by intravascular ultrasound and optical coherence tomography (OCT), three-dimensional (3D) image reconstruction, as well as functional invasive assessment of the significance of coronary artery stenosis (FFR, iFR and RFR). The Unit is the only one in Croatia where alcohol septal ablation is routinely performed in patients with hypertrophic obstructive cardiomyopathy. The Unit also has a device with the possibility of simultaneous recording in two planes ("biplane"), which is mostly used for the diagnosis and interventional treatment of children with congenital heart disease. In this program, Unit’s physicians co-operate with pediatric cardiologists of the Pediatric Department. In addition, intervention procedures in adult patients with congenital heart disease are also performed (persistent foramen ovale closure, atrial septal defect closure, balloon valvuloplasty of the pulmonary valve and percutaneous implantation of the pulmonary valve, pulmonary artery stenting). The Unit’s activities include collaboration in the heart transplant program (routine myocardial biopsies and right-sided cardiac catheterization). Also, extracorporeal oxygenation and blood circulation (ECMO or ECLS) is routinely implanted. In 2020, for the first time in the Republic of Croatia, a complex PCI with percutaneous left ventricular support device was performed.
Due to all the above, the Unit is the Reference Center of the Ministry of Health for invasive and interventional cardiology.