Salerno, record-breaking surgery at Ruggi Hospital: double beating-heart surgery saves a very high-risk patient.

An extraordinarily complex cardiac surgery, performed entirely on a beating heart and without the use of extracorporeal circulation, was completed in the hybrid operating room of the San Giovanni di Dio e Ruggi d'Aragona University Hospital in Salerno.

The team was led by Professor Enrico Coscioni, director of the Cardiac Surgery Complex Operating Unit, supported by a highly specialized multidisciplinary team.

The procedure, described by specialists as unique, made it possible to simultaneously address two very serious heart conditions in a patient considered to be at extremely high surgical risk.

The clinical picture: a very high-risk challenge

The patient suffered from severe aortic valve stenosis, which severely compromised the heart's ability to pump blood to the body, associated with extensive coronary artery disease with significant narrowing of the coronary arteries.

The case was further complicated by the presence of multi-district vascular disease with critical stenosis in the upper and lower limbs and the so-called "porcelain aorta," a rare condition characterized by massive calcification of the aorta. This condition makes traditional surgery extremely dangerous, increasing the risk of stroke and serious ischemic complications.

Double procedure without stopping the heart

The surgery was performed in Ruggi's modern hybrid operating room using a customized surgical strategy.

In the first phase, cardiac surgeons performed an off-pump triple coronary bypass, without stopping the heart, restoring proper blood flow to the heart muscle. Subsequently, through a small direct access to the ascending aorta, they replaced the aortic valve by implanting a biological prosthesis using the TAVI (Transcatheter Aortic Valve Implantation) technique.

The entire procedure was carried out with the heart in continuous activity, avoiding the need for extracorporeal circulation and significantly reducing the risk of postoperative complications.

Personalized medicine and teamwork

The procedure represents an example of "tailored" medicine, built on the patient's specific conditions and based on the integration of cardiac surgery, anesthesia, and advanced diagnostics.

"Every patient is different, and there's no one-size-fits-all solution," explains Professor Enrico Coscioni. "In this case, we adapted the surgery to the patient, not the patient to the surgery, concretely interpreting the concept of personalized medicine."

The Director of Cardiac Surgery also emphasized the crucial role of multidisciplinary work, thanking in particular Professor Ornella Piazza, director of the Complex Operating Unit of Anesthesia and Resuscitation of the Cardio-Thoracic-Vascular Department. He emphasized how the success of such a delicate operation is the result of collaboration between specialists, the sharing of expertise, and the care provided to patients, including during the rehabilitation process and after discharge.

A new milestone for Campania's healthcare system

The successful outcome of the operation represents not only a clinical success, with the patient overcoming the critical phase, but also a major step forward for cardiac surgery in Salerno and for the entire Campania healthcare system.

The procedure confirms how, thanks to technological innovation, highly specialized healthcare professionals, and collaboration between different medical disciplines, it is now possible to successfully address even the most complex cardiovascular diseases, offering new treatment options to patients who, until a few years ago, would have had much more limited therapeutic options.