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Treatment of Aortic Valve Stenosis in European hospitals

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Best hospitals and doctors for aortic valve stenosis treatment abroad

Leading hospitals

Cost for treatment

Diagnosis of aortic valve stenosis
Treatment of aortic valve stenosis with balloon valvuloplasty
Treatment of aortic valve stenosis with transcatheter aortic valve replacement (TAVI)
Treatment of aortic valve stenosis with valve replacement (biological or mechanical)
Cardiac rehabilitation
According to the Focus magazine, the University Hospital Oldenburg ranks among the best medical facilities in Germany! The hospital offers a wide range of medical services that meet the highest medical standards. The hospital has 832 beds. The medical facility annually serves 37,000 patients on an inpatient and partially inpatie
University Hospital Essen

University Hospital Essen

Overall rating9.6 / 10
According to the authoritative Focus magazine the University Hospital Essen ranks among the top German hospitals! With 27 specialized departments and 24 institutes, the hospital in Germany is a maximum care medical facility. The hospital has 1,300 beds for inpatient treatment. A highly qualified medical team of more than 6,000 e
University Hospital Ulm

University Hospital Ulm

Overall rating8.7 / 10
The University Hospital Ulm is an advanced medical complex that provides patients with high-class medical care using the very latest scientific achievements. The medical facility has been performing successful clinical activities for more than 40 years and has long earned an excellent reputation throughout Europe. The hospital r
According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
According to the prestigious medical publication Focus, the University Hospital Tuebingen ranks among the top five German hospitals! The hospital was founded in 1805, therefore it is proud of its long history, unique experience, and outstanding achievements in the field of medical care, as well as research and teaching activitie
According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all fields of
University Hospital Bonn

University Hospital Bonn

Overall rating9.2 / 10
According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
University Hospital Jena

University Hospital Jena

Overall rating8.9 / 10
According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
According to the authoritative Focus magazine, the University Hospital Duesseldorf ranks among the top Germany hospitals! The hospital is an excellent example of a combination of high-quality health care, research and teaching activities. With more than 50,000 inpatients and about 300,000 outpatients every year, the hospital is
According to the Focus magazine, the University Hospital Muenster ranks among the top German hospitals! The hospital belongs to the most prestigious medical institutions in Germany. The hospital is distinguished by a high professionalism of its doctors, state-of-the-art technological equipment and the availability of the most ad
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If the blood flow is reduced due to narrowing of the aortic valve, there is a need for additional heart work, which can eventually lead to valvular heart disease and other heart conditions.

In terms of treatment, doctors may prescribe surgery for valve reconstruction or replacement. If left untreated, aortic stenosis can lead to serious cardiovascular diseases.


  1. Overview
  2. What causes aortic valve stenosis?
  3. Symptoms of aortic valve stenosis
  4. Surgery for aortic valve stenosis
  5. Complications of untreated aortic stenosis
  6. Best hospitals for treatment
  7. The cost of treatment in European hospitals
  8. How to organize the treatment of aortic valve stenosis in Europe?



By itself, aortic valve stenosis occurs in 2% of all cases of acquired malformations; when combined with valve insufficiency, the disease occurs in almost 23% of cases. If the valve leaflets are inflamed, the tissues thicken, causing the valve opening to narrow over time. Also, the flaps can calcify, severely narrowing the usable area of the valve. In normal conditions, the useful area of the valve orifice is up to 3,5 centimeters in diameter; if the orifice decreases to about 1 square centimeter, hemodynamic abnormalities begin to occur.

At first, when the valve lumen is narrowed, the left ventricle compensates for the abnormality by exerting maximum effort, while a person feels no difference in physical condition. Over time, blood begins to accumulate in the cavity, myocardial tissues stretch, the ventricle begins to contract more actively, the heart muscle "gets tired" and loses endurance. The myocardium of the left ventricle becomes hypertrophied, coronary insufficiency develops, and the heart does not receive the necessary blood supply. Because of that, patients with aortic stenosis have a high risk of sudden death due to severe heart failure.

In addition to complete stenosis of the aortic valve, there is relative stenosis, when the aortic valves are intact, but the ascending part of the aorta is sharply dilated due to arterial hypertension or due to loss of elasticity of the aortic wall. Aortic valve stenosis creates a significant obstruction in the blood flow only if the area of the aortic orifice decreases by more than 50%. Keeping even 10% of its normal value is compatible with life. The lengthening of left ventricular systole (contraction time) and increasing pressure in its cavity, as a compensatory reaction to the aortic orifice, narrowing, cause the development of left ventricular hypertrophy. No other malformation can cause the development of such a significant hypertrophy. Since the left ventricle takes part in the compensation of aortic stenosis, the defect runs for a long time without circulatory disorders. A long compensation period is a peculiarity of this disease.

Aortic valve insufficiency is a frequent companion of aortic valve stenosis. Excessive pressure in the left ventricle provokes an increase in pressure in the left atrium, and then in the vessels of the small circle of blood circulation. The changes primarily affect the connective tissue of the valve.

With persistent and progressive inflammation, the valve flaps become deformed, their edges become thickened, they can twist and sag. As a result, the flaps cannot close hermetically, and blood returns to the heart. If the inflammatory process is stopped, the deformation of the valve may continue, for example, due to the formation of scar tissue.

Until recently, it was thought that the degenerative process in the heart valves was of the same nature as general atherosclerosis. As recent research demonstrates, this does not reflect reality. Recent studies show that aortic valve stenosis is not a passive degenerative disease, but the process of an active permanent and staged nature represented by several scenarios of primary progression, including lipid infiltration into the valve flaps, chronic inflammation, and fibrous tissue replacement with osteoblast activation. Active mineralization of the valve by calcium is a typical feature of pathology development. As a result of such degenerative processes, the valve is destroyed, the flaps are deformed, the area of the valve opening decreases and blood outflow from the left ventricular cavity is obstructed. Ultimately, this leads to the development of myocardial weakness and heart failure.

Despite the apparent similarity of the pathogenesis of aortic valve stenosis with atherosclerosis, the prescription of treatment methods proven effective for one disease, showed no effect in the prevention and treatment of another, which has been confirmed by a large number of scientific studies.

What causes aortic valve stenosis?


In case of congenital aortic valve stenosis, narrowing may be due to the incorrect development of the flaps and their fusion, absence of one of the flaps (when there are two instead of three, but they still completely close the valve opening), and finally due to the narrowness of the area, which these flaps are attached to. People with congenital disease mostly have a combination of these structural changes expressed to a greater or lesser extent.

The following diseases may be the cause of acquired aortic valve stenosis:

  • Rheumatism.
  • Infective endocarditis.
  • Infectious diseases.
  • Atherosclerosis.
  • Congenital pathology.

Symptoms of aortic valve stenosis


Aortic valve stenosis is more common in men, especially in the elderly, for example, as a result of calcium deposition on the valve leaflets. In young people, congenital anomalies are the most likely to be the cause of stenosis.

Symptoms in patients with aortic stenosis are determined by the cause of the condition, the nature and course of the disease that caused the defect, and the severity and stage of development of the pathology itself.

In the stage of the disease compensation, patients usually have no complaints. The diagnosis is mostly established by accident. Patients with more severe aortic valve stenosis can have dizziness, fainting, increased fatigue, compressive pains in the heart, and the area of upper back at the physical activity (less often at rest). The combination of compressive pain in the heart area with dizziness and fainting is particularly typical for aortic valve stenosis. The occurrence of attacks of cardiac asthma and dyspnea at rest indicates a significant progression of stenosis. The pallor of the skin is observed.

Clinical manifestations of aortic valve stenosis depend on the severity of the impact of the disease on the body. Thus, some newborns with critical stenosis, whose heart was working alongside great resistance even before their birth, have pronounced symptoms. Such children have frequent breathing and high heart rate, lethargy, and poor appetite. In the most severe cases, these patients may need artificial respiration and treatment in the intensive care unit. They should immediately undergo endovascular or surgical treatment. Non-significant stenoses may not manifest themselves. In such cases, routine monitoring by a cardiologist and periodic cardiac examinations are mostly recommended to help monitor the progression of the stenosis.

Surgery for aortic valve stenosis


Surgery is usually at the core of treatment tactics for aortic valve stenosis. There are different types of surgery that can be used for the treatment of the diagnosis. The main ones include a balloon or surgical valvuloplasty, and conventional or transcatheter aortic valve replacement.

When performing balloon aortic valvuloplasty, the doctor is handling a catheter with an inflatable balloon connected to it. The doctor directs it and when it reaches the targeted location, the balloon inflates and widens the valve, consequently improving blood flow in it. Balloon valvuloplasty manages aortic valve stenosis and its symptoms, especially when we are talking about congenital stenosis, usually in children. However, in adults, even after successful surgery, the results usually do not last. For this reason, doctors rarely use this method of treatment for adult patients, except for those with a general health condition unsuitable for a full-spectrum operation.

In rare cases, surgical valvuloplasty may be more effective than balloon valvuloplasty: for example, for newborns with congenital aortic valve malformation when the valves are fused. With conventional surgical instruments, the cardiac surgeon separates the flaps to reduce the narrowing and improve blood flow.

However, aortic valve replacement is the primary type of the surgical treatment for the severely narrowed aortic valve. During the intervention, the surgeon replaces the affected valve with an artificial valve. This happens during open-heart surgery.

Mechanical valves are durable but carry the risk of blood clotting. If a patient gets such an artificial valve, they will have to take anticoagulant drugs for life. The biological one has to be replaced over time. Another reserved option is the patient's own valve from the pulmonary artery.

Transcatheter aortic valve implantation is a less invasive way for aortic valve replacement.

Transcatheter aortic valve implantation is usually performed for patients with severe pathology who have an increased risk of complications after surgery. However, this type of intervention has greater risks of stroke and vascular complications than conventional aortic valve replacement surgery. This method is relatively new and is developing very rapidly.

Aortic valve stenosis can be effectively treated by surgery. However, patients need to have regular checkups and see a doctor to monitor the health condition. Patients may have a risk of arrhythmia even after treated aortic valve stenosis, which can be regulated with additional medications that reduce the risk. If the heart is weakened by aortic valve stenosis, patients may need medications to treat heart failure.

If patients had surgery for aortic valve replacement, doctors recommend taking prophylactic antibiotics before certain medical interventions to prevent the inflammation of endocarditis.

Complications of untreated aortic stenosis


The heart has four valves at its disposal to keep it working smoothly: mitral and tricuspid, aortic and pulmonary that receive the blood expelled from the heart.

When a heart valve pathology leads to abnormalities in the heart functioning, we can talk about a heart defect. Congenital and acquired defects are distinguished by their origin. According to the mechanism of the resulting disorders, all heart defects are divided into two large groups: stenosis and insufficiency.

Regardless of the origin and specific kind of hemodynamic disorders, the result of the existence of the defect is, eventually, the same – an increased load on the heart, which ultimately leads to the development of circulatory failure and the occurrence of irreversible changes, both in the heart functioning and functioning of other vital organs and tissues (lungs, kidneys, liver, etc.). Therefore, it is necessary to correct the heart defect in time, when it is possible to heal fully and return the patient to an active life without any restrictions.

So, are there any potential consequences of untreated stenosis? Since it pushes the left ventricle to work extra to facilitate the blood getting through the constriction area, it gradually gets worn out working in this mode, which results in different defects in its structure and general disruptions in functioning like stretching of its wall, enlargement of its cavity, and development of heart failure.

If left untreated, aortic valve stenosis causes life-threatening problems to appear, including:

  • Angina pectoris.
  • Frequent fainting.
  • Heart failure.
  • Cardiac arrest.

Best hospitals for treatment


According to statistics, up to 98% of patients who underwent treatment in European hospitals tolerate cardiac surgery well, without any complications. Open heart valve replacement interventions in Europe are performed using sparing surgical techniques, and cardiac surgeons always try to limit the extent of interventions to a minimum. Generally, medical manipulations on the heart are serious operations that impose a bunch of restrictions on the lifestyle of patients. However, the vast majority of people who have undergone cardiac surgery in European hospitals report minimal consequences and a significant improvement in their general health condition. Patients are assured of the satisfactory treatment outcomes in Europe due to high-tech equipment, the vast experience of European doctors, as well as efficiently designed facilities and departments that create conditions for cooperation between doctors of different specializations.

The following hospitals are considered the best in Europe for undergoing aortic valve stenosis treatment:

  • University Hospital Oldenburg, Germany.
  • University Hospital Essen, Germany.
  • University Hospital Ulm, Germany.
  • University Hospital Frankfurt am Main, Germany.
  • University Hospital Tuebingen, Germany.
  • University Hospital Erlangen, Germany.

You can find more detailed information about hospitals and the conditions of stay for inpatient treatment in the Departments of Cardiac Surgery on the Booking Health website.

The cost of treatment in European hospitals


The average prices for aortic stenosis treatment are:

  • The cost of treatment with balloon valvuloplasty starts at 5,165 EUR.
  • The cost of treatment with valve replacement starts at 9,746 EUR.
  • The cost of treatment with transcatheter valve replacement starts at 17,015 EUR.
  • The price of diagnostics starts at 468 EUR.
  • The price of cardiac rehabilitation starts at 566 EUR.

More information about the cost of treatment of aortic valve stenosis in Europe is available on the Booking Health website.

How to organize the treatment of aortic valve stenosis in Europe?


The experience of cardiac surgeons, as well as the use of new treatments for various heart diseases justify an excellent reputation that extends far beyond Europe. To give patients the best possible treatment, doctors have access to modern surgical techniques. But how to actually start the treatment in Europe?

The treatment in European hospitals is easy with services provided by Booking Health.

Whether you need emergency medical care or plan to undergo surgical treatment, you can count on Booking Health in selecting the most suitable hospital and specialist for you. Besides, Booking Health will provide you with a cost of treatment guarantee.

For more information, please leave your request and we will contact you as soon as possible.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko