Atherosclerosis at the Heart of Research
The Cardiovascular Center is involved in several research projects. One of them involves Cardiology in a broad sense and explores the sensitive atherosclerosis problem that affects an increasing number of patients with often serious consequences.
Atherosclerosis: therapeutic education of the patient
Coronary atherosclerosis and of the cerebral arteries is the biggest cause of mortality in industrialized countries and throughout the world. It represents close to 40% of deaths. In Switzerland, around 10,000 people die from heart attacks each year, one every fifty minutes.
International recommendations dedicated to caring for patients with atherosclerosis, especially myocardial infarctions, have contributed to the standardization of hospital treatment and harmonization of medical prescriptions upon discharge from hospital to improve the quality of care and reduce recurrent events and complications.
However, despite these advances in treatment, one patient in seven has a recurrent fatal or non-fatal cardiovascular event within 12 months of the infarction.
The missing link in patient support is simply: therapeutic patient education. Indeed, therapeutic education involves several personal dimensions that influence patient behavior regarding their illness and treatment.
To fill this gap, the Cardiology Division of Geneva University Hospitals has developed the ELIPS® program based around a DVD translated into several languages and specialized training of health workers to interact with the patient in a motivational listening mode.
A clinical study involving all university hospitals in Switzerland (over 4,000 patients included) is underway to assess the clinical benefits of this program and to fully take advantage of the therapeutic progress within the framework of patients hospitalized for a heart attack, well beyond the scope of hospitalization, to further reduce the recurrence of clinical events related to atherosclerosis.
Cardiovascular surgery has focused its fundamental research efforts on theuse of biodegradable materials in the cardiovascular domain. The HUG specialized division has developed the first biodegradable ring, which received the CE Mark in 2005.
This ring is made from a polymer, polydioxanone, unlike conventional rings on the market, it is implanted within the mitral or native tricuspid annulus. After six months of implantation, the ring is gradually degraded by inducing a fibrous tissue that functions as an intra-annular durable prosthetic ring.
The primary advantage of the biodegradable ring is that it does not interfere with the growth of the mitral or native tricuspid annulus in a growing child. Its use opens up new repair opportunities in pediatric patients suffering from mitral or tricuspid valve disease.
Unlike conventional rings, the biodegradable ring does not require anticoagulation during the first 3 months after implantation. The fact that it is stripped of any synthetic material considerably reduces the risk of infection and its three-dimensional flexibility also makes it much easier to use in minimally invasive or robotic surgery.
The Cardiovascular Surgery Division is also making progress on the development of a biodegradable vascular prosthesis to perform bypasses, in cases which require the use of small diameter prostheses.
A third project to develop a biological valve prosthesis is underway. Experimental studies have been completed with promising results on a hemodynamic level and the clinical study should start soon. The advantage of this bio-prosthesis over conventional aortic bio-prostheses is due to the fact that it will have a similar hemodynamic performance at physiological values even for small sizes.
Divisions affiliated to the Cardiovascular Center (medical specialties) also fulfill a training mission, mainly at the postgraduate level..