Department of Cardiac Surgery

Inselspital Bern

The Department of Cardiac Surgery is the largest institution of its kind in Switzerland, providing the entire spectrum of adult and pediatric cardiac surgery, with a special emphasis on reconstructive valve surgery, heart failure and aortic surgery including thoraco-abdominal repair.

To the Inselspital website

Director and Chief Physician

Prof. Matthias Siepe

Profile

  • The Department of Cardiac Surgery, integral to the cardiovascular center, interfaces with the departments of cardiology, vascular surgery and angiology to address the full spectrum of congenital and acquired cardiac diseases. Facilitated by the establishment of disease-centered teams comprising surgical, interventional, diagnostic and ward doctors who work together to provide optimal patient care, this collaborative, interdisciplinary approach provides the ideal environment to foster advancement in individualized and state-of-the-art cardiovascular medicine.
  • We are committed to providing a high-quality training environment at multiple levels – from courses for medical students (clinical skills, problem-based learning) including Master in Medicine and MD Dissertation supervision, to residency programs and specialty, post-graduate education. Individualized PhD and MD-PhD training programs are created in conjunction with the Cardiovascular Research PhD Specialization Program and the graduate schools of the University of Bern.
  • Our dynamic clinical and translational research teams focus on investigating multiple cardiac and vascular disease mechanisms and developing innovative therapeutic approaches. They comprise core members of the Cardiovascular Disease Program and the Cluster for Cardiovascular Research Bern.

Grants

  • Swiss Heart Foundation Research Grant “Transcatheter aortic valve implantation vs surgical aortic valve replacement in patients with bicuspid aortic valve stenosis”; Prof. M. Siepe
  • SNSF Scientific Exchange Grant “Ex-situ heart perfusion: Heart transplantation and beyond”; Prof. S. Longnus
  • Bern Interdisciplinary Grant (BIND Grant) University of Bern “Diagnosis of coronary microvascular obstruction with ultrasound localization microscopy”; Prof. D. Obrist, Prof. S. Longnus
  • SAMS MD-PhD Grant “Ex-vivo heart perfusion enables innovations in cardiac transplantation and precision therapies”; Dr. R. Ottersberg, Prof.
  • M. Siepe, Prof. K. Odening, Prof. S. Longnus
  • Innosuisse & SNSF Bridge – Proof of Concept “TightValve – First surgical device for measuring valve leakage during heart surgery”;
  • Dr. E. Zimmer
  • Strategic Funding Board of the Faculty of Medicine, University of Bern “Ex-vivo Heart Perfusion – Technology that innovates cardiac transplantation and precision therapies”; Prof. M. Siepe, Prof. K. Odening, Prof. S. Longnus
  • Swiss Heart Foundation Research Grant “Sex- and age-specific effects on cardiac graft quality in DCD heart transplantation: Studies in a porcine model”; Prof. S. Longnus
  • SNSF Project Grant “Cardiac metabolism as a basis for sex differences in ischemic tolerance and a target for reperfusion therapy in heart transplantation with donation after circulatory death”; Prof. S. Longnus

Highlights 2025

Optimised perfusion protocol in DCD setting leaving out cardioplegic flushes and arrested heart sequences.

Innovating clinical protocols in DCD heart transplantation to optimize cardiac graft function and recipient outcomes

Following the introduction of donation after circulatory death (DCD) and ex-situ heart perfusion in Switzerland in 2023, our heart transplantation team has focused on optimizing clinical procedures in line with current evidence to further enhance cardiac graft performance and reduce primary graft dysfunction. By avoiding a second cardioplegic arrest during ex-situ perfusion and adopting a beating-heart implantation strategy, we minimize ischemic time and reduce the need for postoperative mechanical circulatory support. Building on this approach, and guided by promising yet unpublished data, we have recently eliminated the initial cardioplegia during organ procurement. In this setting, the heart is directly transferred to the Organ Care System (OCS) and typically resumes activity immediately, often without the need for defibrillation or pacing, and demonstrates lactate production within expected ranges.

Distribution of functional outcome after stroke. A, The pie chart illustrates the distribution of functional outcomes among individuals who have experienced stroke. Each segment of the pie chart corresponds to the functional outcomes 1 year after TAAD, depicting the percentage of patients residing independently at home, those receiving support at home, or those residing in an assisted- living facility. B, Distribution of functional outcome after CT/MRI- confirmed stroke. CT indicates computed tomography; MRI, magnetic resonance imaging; and TAAD, Stanford type A aortic dissection

Establishing the standard of care in aortic surgery

Aortic surgery is an important clinical and scientific focus of the department. As one of the largest aortic centers in Europe, the Bern Aortic Center contributes to international guidelines and is setting the standard of care for patients presenting with aortic aneurysms and dissection with several of our reports being cited in current US and European guidelines.

de Backer et al., Eur Heart J. 2025

Yildiz et al., J Am Heart Assoc. 2025

Mosbahi et al., Ann Cardiothorac Surg. 2025

International Symposium on Ex-Situ Heart Perfusion

The first international symposium, “Ex-situ heart perfusion: Heart transplantation and beyond” was held in Bern with the support of SNSF Scientific Exchange funding. The symposium was positively received, attracting global experts from basic/translational research and clinical practice, as well as industry leaders, from Austria, Germany, the Netherlands, the UK and the US. The objectives of stimulating innovation in ex-situ heart perfusion by fostering interdisciplinary exchange and efficient advancement in the field through new collaborative research approaches were successfully achieved, as was the goal of integrating and promoting early career investigators through multiple presentation and networking opportunities.

LV work (developed pressure-heart rate product) dP/dtmax and heart-type fatty acid binding protein (H-FABP) release demonstrated significant predictive ability to discriminate between grafts with high and low ventricular function

New myocardial biomarkers for DCD cardiac graft quality identified in a preclinical model

In our recent study published in the American Journal of Transplantation, we have identified new biomarkers for DCD heart transplantation. Using a porcine model of DCD with varying durations of warm ischemia to generate a range in recovery of cardiac grafts, we report several myocardial functional and biochemical biomarkers that are enabled by ex-situ heart perfusion. New biomarkers for DCD cardiac graft quality are of particular interest as current clinical protocols are heavily reliant on lactate profiles, which have been reported as suboptimal. The specific myocardial biomarkers identified in this study hold particular promise as they are readily amenable to clinical application and should improve our precision in cardiac DCD graft evaluation.

Egle et al., Am J Transplant. 2025