Although the first ideas about the development of cardiovascular surgery were conceived in the early 1960s, the idea came to fruition in 1973, when today’s Institute of Cardiovascular Diseases “Dedinje” began operating as one of the departments of the Clinic of General Surgery of CHC “Dr Dragiša Mišović”. The new building, where then Institute for Cardiovascular Surgery started working, was completed at the end of 1977. The first director of the Institute was Prim. Dr. Dragoljub Adamov, and the Institute originally had 60 employees. In 1985, the Institute was fully functionally separated from the CHC “Dr Dragiša Mišović” and continued to operate under the name Clinic for Cardiovascular Surgery “Dedinje”. Since 1993, this institution has operated under the name the Institute for Cardiovascular Diseases “Dedinje”, which is the name it still carries. In 1996, a new building of the Institute was opened, which significantly increased the accommodation, diagnostic and therapeutic capacities.

Prim. Dr. Dragoljub Adamov

Cardiac surgery

The today’s Institute for Cardiovascular Diseases “Dedinje” emerged from the Department of Vascular Surgery of the General Hospital “Dr Dragiša Mišović”. Upon its establishment this department had several rooms on the 3 rd floor, when prim. dr Dragoljub Adamov was appointed as the first head of the department. It all began with venous system operations, and surgical intervention on arteries followed soon after. The number of treated and operated patients was constantly growing, which indicated the necessity of the construction of a separate specialized institution which would provide diagnostics and treatment for cardiovascular patients. Thanks to prof. dr. Libor Hejhal and the Mayor of Belgrade at that point, Branko Pešić, a completely new and functional building was built and equipped within the complex of CHC “Dr Dragiša Mišović”, which had the opening ceremony in October, 1977.

Prof. Dr. Libor Hejhal

The institution was a functional unit consisting of the divisions for radiology, cardiology and cardiovascular surgery. During the first two years of operation, only myocardial revascularization procedures were performed and the staff became completely independent. The institute gained an enviable reputation in medical community, but there was still a problem with accommodation capacities, since there were only 88 beds in total for all divisions. Many world experts participated as guests in diagnostic procedures or operated on patients with the assistance of medical doctors from the Institute (L. Hejhal, R. Hackee, F. Von der Emde, A. Carpanter, Y. Chavaouh).

Alain Carpentier M.D, PhD

Prof. Dr. Mihailo Vučinić

Medical doctors of the Institute completely mastered complicated surgical revascularization procedures and heart valve surgery. In 1985, the Institute was fully functionally separated from the CHC “Dr Dragiša Mišović” and continued to operate under the name Clinic for Cardiovascular Surgery “Dedinje”. In 1986, Prim. Dr. Dragoljub Adamov retired, and Prof. Dr Mihailo Vučinić was appointed director of the Institute. Prof. Dr Mihailo Vučinić remained in that position until his retirement in 1992. Significant names in the field of cardiac surgery stayed and performed operations as guests of the Institute: Dudley Johnson, Geoge Reul, Donald Ross, Andzej Dziatkonjiak. In 1992, Prof. Dr. Milovan Bojić became the head of the Institute.

Construction of a new division of the Institute started after the expansion of capacity. The number of beds increased to just over 200, while the number of employees increased to almost 600. All this allowed for the number of cardiac surgery procedures to increase to about 2,000, making the Institute one of the largest centers in Europe. Since 1993, after a continuous expansion in terms of the type and number of interventions, this institution has been operating under the name the Institute for Cardiovascular Diseases “Dedinje”.

Prof. Dr. Milovan Bojić

Prof. Dr. Boško Đukanović

The first heart and liver transplantations were performed in 1995. With the assistance of an expert from the Texas Heart Institute (H. Frasier), the heart-mate was implanted for the first time in this region as a temporary mechanical heart to provide support until the foreseen transplantation. International cooperation was still very active.

During 2000, Prof. Dr. Boško Đukanović became the head of the Institute, who expanded the selection of procedures in the field of aortic surgery, thus enabling the Institute to become the leading institution in this field in the entire region.

In January 2016, prof. dr Predrag Milojević took over the position of Acting Director of the Institute.

However, in October, 2017, Prof. Dr. Milovan Bojić was once again appointed as the head of the Institute for Cardiovascular Diseases “Dedinje”.

Prof. Dr. Predrag Milojević

Vascular surgery

The Department of Vascular Surgery of the General Hospital “Dr Dragiša Mišović” started working in 1973, and the first chief was Prim. Dr. Dragoljub Adamov. Unselfish help in the development of the department of vascular surgery in that initial period was provided by prof. Dr. Libor Hejhal from the IKEM Institute in Prague, both through his direct participation and the training of our doctors in Prague. The first operations were performed on the superficial and deep venous system, and soon on the main arteries of the neck and extremities, while surgical procedures on the visceral arteries were introduced later.

Prim. Dr. Dragoljub Adamov

The relocation to the new building in 1977 resulted in a significant increase in the scope and complexity of surgical procedures. In the period 1977-1992 prim. dr Miodrag Jevremović was the head of vascular surgery, the position which was later taken over by the scholar prof. dr. Đorđe Radak, who held that position until 2019.
In the early 1990s, modern diagnostic and therapeutic surgical procedures were introduced, including open surgical interventions to treat portal hypertension and liver and pancreas transplant surgery. The first successful transplantations were performed in 1995. Eversion carotid endarterectomy was introduced as a standard in the surgical treatment of carotid disease. Three decades later, more than 18,000 of these procedures were performed, with above-average results at the level of the world’s best centers.
Cooperation with experienced invasive radiologists at our institute has resulted in the development of various endovascular interventions in treating abdominal aorta, carotid and peripheral arteries. The first implantation of an aortic stent graft was performed in 2004, after which the number of these procedures has been growing steadily on an annual basis, with excellent results.
The Clinic for Vascular Surgery is the first and the only state institution that provides patients with modern treatment of chronic venous disease by applying the method of endovenous laser ablation (EVLA). The first intervention was performed by doc. dr. Predrag Matić in April, 2019, and the minimally invasive nature of this procedure attracts more and more patients.
Since 2019, prof. dr. Nenad Ilijevski has been the head of the Clinic for Vascular Surgery, who made his first surgical steps in 1988, at the clinic he now manages. Prof. dr Đorđe Radak

Prof. Dr. Đorđe Radak

ANESTHESIOLOGY

This department started operating in 1973 within the Institute of Cardiovascular Surgery of CHC “Dr Dragiša Mišović” as the Department of Anesthesiology and Resuscitation within the Clinic for Anesthesiology, Resuscitation and Pain Therapy CHC “Dragiša Mišović” managed by the director of the clinic, prof. Dr. Predrag Lalević. Upon the establishment of the Clinic for Cardiovascular Surgery “Dedinje”, in 1985, the Department of Anesthesiology and Resuscitation had 6 medical doctors – specialists in anesthesiology and resuscitation with the head of the department Prim. Dr. Ilija Trifunović and 10 nurses and anesthetic medical technicians distributed in 4 operating theaters and about 34 nurses and intensive care medical technicians covering 15 beds. Soon after, in the early 1990s, intraoperative blood salvage and acute normovolemic hemodilution became a part of everyday practice, thus creating conditions for about 40% of cardiac surgery patients to avoid receiving allogeneic (donor’s) blood. A heart and liver transplantation program was introduced at the Institute for Cardiovascular Diseases “Dedinje” in 1995. The team of anesthesiologists, nurses and technicians in charge of anesthesia and intensive care unit at that point made a significant step forward in the field of contemporary transplant medicine, with successful heart and liver transplants as a part of the Institute’s Transplant Team and Medical Advisory Board, led by prof. dr Božin Radević and doc. Dr. Boško Radomir, Head of the Department of Anesthesiology and Intensive Care. The following year, 1996, just six months after its introduction, a program of surgical left ventricle remodeling in case of dilated cardiomyopathy was mastered. This program improved and encouraged obtaining new knowledge and experience in the field of cardiac insufficiency. At the same time, the implementation of the surgical thoracic aorta reconstruction program was intensified, which improved the anesthesiological concept of modern anesthesia in deep hypothermic circulatory arrest as well as intensive care, by introducing high thoracic epidural anesthesia, continuous intraoperative blood salvage and acute normovolemic hemodilution, along with introducing combined epidural and general anesthesia (fast-track) into cardio-anesthesia for coronary artery bypass grafting, thanks to many years of experience of the anesthesiology team in applying the same concept in vascular anesthesia.

Prof. Dr. Predrag Lalevic

CARDIOLOGY AND RADIOLOGY

The departments of cardiology and radiology started working in 1973, and significantly expanded their fields of activity immediately after the opening of the new clinic building in October 1977. The first head of the Department of Cardiology was Prim. Dr. Petar Pejčić, and the Department of Radiology Prim. Dr. Zoran Đurišić. In the period 1973-1977. year, the main activity of both departments was the diagnosis and preparation of patients undergoing vascular surgery, as well as their further management in the postoperative course. The first arteriography was performed in 1976, and phlebography and splenoportography were successfully introduced in the same year. By moving to the new building, the technical possibilities of these two departments were significantly expanded, because the most modern X-ray machine was purchased at that time. The first coronary angiography was performed in 1977.

The coronary angiography team (doctors Pejčić, Đurišić and Grujičić, technician Nikolić and nurse Lekić) previously had a detailed training supported by professors Fabian and Belan from Prague. After the establishment of the Department of Cardiac Surgery in 1978, the Department of Cardiology took over pre- and postoperative care of these patients. The first percutaneous coronary intervention, which was performed in December, 1981, emerged as a logical result of introducing the latest treatment methods at the Clinic for Cardiovascular Surgery “Dedinje”. The year before, Dr. Đurišić and Dr. Grujičić performed a similar intervention on the femoral artery. Dr. Uroš Babić has a special place in the history of Serbian invasive cardiology who significantly improved the treatment of patients suffering from mitral stenosis and atrial septal defect on a global scale, thanks to his innovative approach. In the period 1985-1989, Dr. Babić developed original treatment methods for these patients and, together with dr Grujičić, he was the first to apply them in everyday clinical practice. The first stent was implanted in the femoral artery in 1990 by dr Grujičić and dr Đurišić, and six years later the first stent was implanted into the coronary artery by prof. dr Dragan Sagić and prof. dr Milutin Mirić. The transfer into the new building in 1996 was the turning point in the further development of cardiology and radiology. This resulted in a significant increase in the accommodation and diagnostic-therapeutic capacities. The new building accommodated 4 X- ray rooms and a space for a scanner, which was purchased in 2005. The increase in the scope of work resulted in the need to provide new organization. Therefore, the Clinic for Cardiology and the Center for Invasive and Interventional Cardiovascular Diagnostics and Therapy were established.

Dr Sreten Grujičić

The new millennium brought new challenges in the treatment of cardiovascular patients. Therefore, in 2004 the first aortic stent graft was implanted (prof. dr Sagić, dr Antonić, prof. dr Radak). The first permanent pacemaker (type VVI) at the Institute and in Serbia was implanted by prim. dr Dragoljub Adamov in 1966. The Department of Electrophysiology and Electrostimulation was established in 1996. A year later, dr Lazar Angelkov implanted the first cardioverter defibrillator, and in 1998 a multisite pacemaker for cardiac resynchronization therapy was implanted for the first time in Serbia to treat cardiac insufficiency. The first radiofrequency ablation at the Institute was performed in 1994 by prof. Dr. K.H. Pittschner from Bad Nauheim (Germany). This procedure was later on mastered by medical doctors Vukajlović and Angelkov. Cardiac ultrasound diagnostics (echocardiography) has been performed at the Institute for Cardiovascular Diseases “Dedinje” since 1985. The Center for Cardiovascular Research was also established in 1996 and is the result of an idea of doc. dr Aleksandar D. Popović to unite and coordinate the outstanding scientific and research potential of the entire Institute in one place.

Doc. Dr. Aleksandar D. Popović