The diagnostic-therapeutic and care path consists of an initial consulting phase during which all the assessments necessary to define the patient’s state of health are performed. At the end of this phase, the specialist will be able to establish the most appropriate treatment for meeting the needs of the patient.
Several types of surgical activities are performed at the hospital:

• Mini-invasive cardiac surgery for valve and coronary artery operations;
• Myocardial revascularisation with arterial (left internal mammary artery, right internal mammary artery, radial artery) and venous (great saphenous vein) conduits;
• The more frequent use of the mammary arteries alone produces a clinical benefit tied to the greater duration of the by-pass over time;
• Mitral, aortic, tricuspid valve replacement and/or plastic & reconstructive surgery. Mechanical or biological prostheses are used in the event of replacement. Among the latter we find the new generation prostheses, which last longer and are much more similar to normal human anatomy and physiology, such as stentless prostheses and porcine roots, which include valve and aortic root;
• Aortic root replacement;
• Aortic arch replacement surgery;
• Cardiac arrhythmia surgery (Atrial Fibrillation);
• Heart failure surgery, which includes not only extreme surgical revascularisation, but also repair of the ischaemic mitral valve and left ventricular plastic & reconstructive surgery.

Vascular Surgery, including:

• Thromboendarterectomy (TEA) of the carotid arteries
• Thoracic aorta and abdominal aneurysmectomy
• Lower limb revascularisation (aortobifemoral, femoropopliteal, femorofemoral, extraperitoneal iliofemoral, axillo-bifemoral by-passes) in saphenous vein and prostheses.

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Spitali Europian, using both invasive and non-invasive methods and procedures, provides clinical and interventional cardiology services on both an outpatient and inpatient basis.
The non-invasive procedures include:

• Baseline and pharmacological stress echocardiogram
• Ultrasound of the arteries (carotid arteries, renal arteries, arteries of the lower limbs), study of the peripheral vessels of the limbs
• Holter Monitor (continuous monitoring of cardiac activity during the patient’s routine activity)
• Continuous electrocardiographic monitoring, in bed or through telemetry
• Ergometric test (exercise electrocardiogram)

The invasive procedures are performed in the haemodynamics laboratories and usually become necessary when situations are detected that cannot be treated with pharmacological therapy alone.Close

The unit performs the following activities:

• Digestive tract surgery
• Surgery of the female genital apparatus
• Surgery of the male genital apparatus
• Gall bladder surgery
• Breast surgery
• Abdominal wall surgery (hernias and incisional hernias)
• Surgery for disorders of the skin, subcutaneous tissue and skin appendages
• Endocrine surgery

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The invasive procedure consists of the insertion of small catheters into the vascular system which, going through the blood vessels, reach the sector concerned by the disease: heart, cardiac and coronary valves, carotid, aorta, peripheral arteries, etc. It is possible in this way to study heart function and the state of the arterial system (coronary catheterisation, angiography, etc.) or to intervene for therapeutic purposes (angioplasty and stent implantation, valvuloplasty, etc.), thus avoiding surgery in many cases.
Some of the reference exams are:

• Angiography of the thoracoabdominal aorta;
• Angiography of the supra-aortic trunks;
• Selective angiography of the renal arteries and of the celiac tripod;
• Angiography of the lower extremity arteries (iliofemoral-popliteal and tibioperoneal district);
• Percutaneous transluminal angioplasty (directional atherectomy/cutting, medicated and non-medicated stent implantation).
• Peripheral angioplasty (carotid and subclavian-vertebral district, renal and mesenteric arteries, iliofemoral-popliteal and tibioperoneal axis, diabetic foot).
• Left and right cardiac catheterisation
• Left and right selective coronary arteriography
• Percutaneous implantation of endoprostheses in the thoracoabdominal aorta.
• Left and right ventriculography
• Assessment of cardiac output, mitral valve area, transvalvular gradients, intracardiac shunts.

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The anaesthesiologists of the team follow the patient during all phases, from the preoperative anaesthesiological assessment to assistance in the operating room to the period of awakening.

Anaesthesiology assistance is also provided to the various wards and services (Cardiology, Haemodynamics, Radiology, general surgery, etc.), for every possible problem within its competence, with the possibility of transfer to Intensive Care.

Special attention is paid to rapid recovery of the state of consciousness and well-being of the patient. For this reason the search for the use of last generation drug products is continuous.

At the end of the most complex operations (cardiosurgical and neurosurgical), the patient is transferred to Intensive Care, where he/she is monitored by expert medical and nursing staff capable of controlling and dealing with any possible postoperative complication, thanks also to the availability of state-of-the-art monitoring equipment.Close

The services provided on an outpatient basis may involve

1. Tooth extraction, including wisdom teeth
2. Implantology
3. Periodontal surgery
4. Surgical treatment of oral pathologies:
   • removal of cystic lesions
   • diagnostic biopsies
   • excision of neoformations
   • frenectomies

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The pathologies treated range from degenerative diseases (arthrosis of the knee, hip and shoulder) to be treated with prosthesis implantations, to those more typically associated with sports, both for the lower limb (ligament and meniscal pathologies) and for the upper limb (tendon pathologies and shoulder instability).
Hospitalisation times for pathologies treated arthroscopically range from one to two days, while for operations with the insertion of hip, knee or shoulder prostheses, the operated patient is transferred on the fifth day to the Functional Rehabilitation Unit so as not to interrupt the educational programme.
Activities performed

• Knee surgery modules
• Painful pathology of the foot
• Shoulder surgery module
• Mini-invasive prosthetic surgery
• Cartilage transplants
• Hip surgery even in the elderly: fractures and prostheses

Treated pathologies
Pathologies of the knee

• Gonarthrosis
• Axial deviations (varus-valgus knee)
• Pathologies of the patella (pain – instability)
• Meniscal pathologies
• Cartilage pathologies
• Ligament pathologies

Hip pathologies

• hip dysplasia
• coxarthrosis

Hand pathologies

• Carpal tunnel
• Trigger finger
• Tenosynovitis

Pathologies of the foot

• Bunions
• Metatarsalgia
• Hammer finger
• Flat feet

Pathologies of the shoulder

• Instability
• Tendon pain and
• injuries (periarthritis)
• Glenohumeral osteoarthritis

Traumatic pathologies

• Hip (femur)
• Knee
• Foot
• Shoulder

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A list of the main surgical activities is provided below:

• Surgery of the Nose
• Morphofunctional surgery of the nose
• Surgery of the nasal septum and valve
• Endoscopic surgery of nasal polyps, paranasal sinuses
• Septal perforation surgery
• Choanal diaphragms, nosebleed
• Surgery for snoring
• Endoscopic adenoidectomy
• Adenotonsillectomies
• Oral cavity surgery
• Salivary gland surgery
• Larynx and Neck surgery
• Microlaryngoscopy diagnosis
• Benign and malignant laryngeal surgery
• Functional reconstruction laryngeal surgery
• Thyroid and parathyroid surgery
• Lateral and median neck cysts

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