google_counter
Mitral Valve Stenosis Treatment in Germany | Best Hospitals | Clinics | Prices | Booking Health

Treatment of Mitral Valve Stenosis in Germany

Mitral valve stenosis Treatment in Germany | Information about hospitals of Germany and cost of treatment | Rankings | Clinics | Prices | Send request to the hospital and find out price for treatment of Mitral valve stenosis in Germany

Best hospitals and doctors for mitral valve stenosis treatment in Germany

Leading hospitals

Cost for treatment

Diagnosis of mitral valve stenosis
1802
Treatment of mitral valve stenosis with balloon valvuloplasty
12054.53
Treatment of mitral valve stenosis with valve commissurotomy
24807.8
Treatment of mitral valve stenosis with valve replacement (biological or mechanical)
30323
Cardiac rehabilitation
0.00
University Hospital Hamburg-Eppendorf
Germany, Hamburg
University Hospital Hamburg-Eppendorf
Overall rating9.2 / 10
According to the Focus magazine, the University Hospital Hamburg-Eppendorf is one of the top ten hospitals in Germany! Since its foundation in 1889, the hospital has taken a leading position in the European medical arena, which it still holds today. A highly competent medical team of more than 15,300 employees takes care of the
certificatecertificatecertificatecertificatecertificate
University Hospital Saarland Homburg
Germany, Homburg
University Hospital Saarland Homburg
Overall rating9.8 / 10
The University Hospital Saarland Homburg is the largest hospital in the city of Homburg and the most important medical facility in the region. The hospital, which currently has 30 specialized departments and 20 institutes, was founded in 1947 and operates on the basis of Saarland University. The hospital plays a leading role in
certificatecertificate
HELIOS University Hospital Wuppertal
Germany, Wuppertal
HELIOS University Hospital Wuppertal
Overall rating9.8 / 10
According to the prestigious Focus magazine, the HELIOS University Hospital Wuppertal ranks among the top medical facilities in Germany! The hospital rightfully enjoys the status of the maximum care medical facility and provides its high-quality services in all modern fields of medicine. The hospital operates on the basis of the
certificatecertificatecertificatecertificate
University Hospital Marburg UKGM
Germany, Marburg
University Hospital Marburg UKGM
Overall rating9 / 10
The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
HELIOS Heart Surgery Clinic Karlsruhe
Germany, Karlsruhe
HELIOS Heart Surgery Clinic Karlsruhe
Overall rating9.9 / 10
According to the prestigious Focus magazine, the HELIOS Heart Surgery Clinic Karlsruhe ranks among the top German medical facilities specializing in the surgical treatment of cardiovascular diseases! The clinic opened its doors to patients in 1995 and since then has been a leader in the European medical arena. The medical facili
certificatecertificatecertificate
Municipal Hospital Karlsruhe
Germany, Karlsruhe
Municipal Hospital Karlsruhe
Overall rating9.8 / 10
The Municipal Hospital Karlsruhe is a modern maximum care medical facility, which combines a long tradition and the advanced achievements of modern medicine. The hospital operates on the basis of the University of Freiburg, so scientific innovations in the field of diagnostics and treatment are continuously introduced into pract
certificate
Hannover Medical School (MHH)
Germany, Hannover
Hannover Medical School (MHH)
Overall rating9.8 / 10
The Hannover Medical School has the status of a leading German medical facility. The advanced medical technologies, highly qualified specialists, as well as productive research activities form a solid basis for top-class medical service of the world standard. The hospital is proud of its outstanding achievements in the treatment
certificatecertificate
Nuremberg Hospital
Germany, Nuremberg
Nuremberg Hospital
Overall rating9 / 10
According to the reputable Focus magazine, the Nuremberg Hospital ranks among the top German medical facilities! The hospital is one of the largest, highly specialized medical centers in Europe and positions itself as the maximum care hospital. The healthcare facility is an academic hospital of the Paracelsus Medical University
certificatecertificate
Heart and Diabetes Center NRW Bad Oeynhausen
Germany, Bad Oeynhausen
Heart and Diabetes Center NRW Bad Oeynhausen
Overall rating9.7 / 10
According to the prestigious Focus magazine, the Heart and Diabetes Center NRW Bad Oeynhausen ranks among the top German hospitals in the area of its specialization! The center is one of the leading medical facilities specializing in the treatment of cardiovascular diseases and diabetes mellitus at the international level. About
certificatecertificatecertificatecertificatecertificate
Hospital Kassel
Germany, Kassel
Hospital Kassel
Overall rating9.9 / 10
The Hospital Kassel is a progressive medical facility with a huge medical team, which provides high-quality medical services in all branches of modern medicine. The hospital is part of the regional medical Gesundheit Nordhessen Holding, which unites 5 top-class medical centers, including specialized rehabilitation clinics. With
certificatecertificate
Hospital Bogenhausen Munich
Germany, Munich
Hospital Bogenhausen Munich
Overall rating7.8 / 10
According to the reputable Focus magazine, the Hospital Bogenhausen Munich ranks among the ten best medical centers in Bavaria and among the top 50 medical facilities in Germany! The medical facility is the Academic Hospital of Ludwig Maximilian University of Munich. The modern hospital with the highest level of services annuall
certificate
Helios Hospital Siegburg
Germany, Siegburg
Helios Hospital Siegburg
Overall rating9.4 / 10
The Helios Hospital Siegburg enjoys an excellent reputation in North Rhine-Westphalia and throughout Germany. The healthcare facility provides comprehensive medical care that meets current clinical protocols and international standards. The hospital has more than 350 beds. The hospital employs a highly motivated team of doctors
University Hospital Mainz
Germany, Mainz
University Hospital Mainz
Overall rating9.7 / 10
The University Hospital Mainz is one of the best maximum care medical facilities in Germany and an internationally recognized scientific center. There are more than 60 departments and institutes, which represent all fields of modern medicine. The hospital serves more than 68,000 inpatients and more than 273,000 outpatients annua
German Heart Center Munich
Germany, Munich
German Heart Center Munich
Overall rating9 / 10
The German Heart Center Munich is a specialized medical facility for treating cardiovascular diseases in patients of all ages that combines long traditions, unique experience, and the highest level of competence among doctors. The center began its work in 1972 and, during that time, became the etalon Heart Center at the internat
University Hospital Freiburg
Germany, Freibung
University Hospital Freiburg
Overall rating9.7 / 10
The University Hospital Freiburg is famous for its rich history and is one of the oldest and most prestigious medical facilities in Germany (one of the three best medical institutions in the country). The hospital was based on the Faculty of Medicine of the Albert Ludwig University of Freiburg, which celebrated its 550th anniver
HELIOS Clinic Krefeld
Germany, Krefeld
HELIOS Clinic Krefeld
Overall rating9.7 / 10
Founded in 2014, the HELIOS Clinic Krefeld is one of the most modern medical facilities in Germany today. A team of highly qualified specialists, innovative medical equipment and comfortable accommodation conditions – the clinic has everything to make the treatment run smoothly and efficiently. Having crossed the threshold
| from Booking Health GmbH

Narrowing of the atrioventricular orifice can occur due to changes in subclavian structures, and fibrous degeneration of the valve ring. This creates an obstruction of blood flow, accompanied by decreased circulation volume.

Content

  1. Mitral stenosis overview
  2. Clinical manifestation
  3. What causes mitral valve stenosis?
  4. Mitral stenosis as a complication of aortic valve replacement
  5. Combined cardiac valve impairment
  6. Complications of mitral valve stenosis
  7. Treatment principles in hospitals in Germany
  8. Surgical options for mitral valve stenosis
  9. The recovery period after surgery
  10. Prognosis
  11. Which hospitals in Germany choose for treatment?
  12. The cost of treatment
  13. How to start treatment in Germany?

Mitral stenosis overview

 

In mitral stenosis, the left atrium is overloaded with pressure, and over time it becomes overstretched. When the left atrium can no longer withstand such an overload, the pulmonary veins above the left atrium start actively supporting the process. But sooner or later they also cease to cope with high-pressure levels, and as a result, blood begins to leak from the pulmonary veins into the lung tissue. As a result of such "flooding", part of the lung tissue ceases to fully participate in gas exchange. To compensate for the resulting oxygen deficit, the rest of the lung tissue will try to increase gas exchange, due to which shortness of breath occurs. With further development of disease, the entire small circle of circulation, up to the right ventricle will be subjected to blood overflow. When the right ventricle will be involved in "solving this problem", there will be fluid overflow in the large circle of circulation, therefore, many unpleasant symptoms will appear.

Clinical manifestation

 

Mitral valve stenosis is manifested by thickening or convergence of the cusps, reduction of the size of valve’s opening. As a result, blood flow is impeded, and the left atrium begins to work with an increased load. This causes the left atrium to enlarge.

Due to the decreased mitral orifice area, the pressure increases in the left atrium and then in the pulmonary veins, through which oxygen-enriched blood from the lungs enters the heart. Usually, the pressure in the pulmonary arteries begins to increase when the diameter of the orifice becomes less than 1 cm, compared to the normal 4-6 cm, spasm occurs in the pulmonary arterioles, which aggravates the process. Thus, the so-called pulmonary hypertension is formed, the long-term existence of which leads to sclerosis of the arterioles that cannot be treated even after the elimination of stenosis.

With the disease, hypertrophy, and expansion, first of all, of the left atrium, and then of the right heart occurs.

At the beginning of the formation of the disease, the symptoms are hardly noticeable. Further on the first place is given to dyspnea, cough under physical load, and then at rest. There may be hemoptysis, persistent pain in the heart, and arrhythmia. If the process progresses, pulmonary edema can develop during physical activity.

There are physical signs of mitral stenosis: diastolic murmur in the heart, chest trembling corresponding to this noise is felt, the boundaries of the heart change. An experienced specialist can often make a diagnosis with a close examination of the patient.

What causes mitral valve stenosis?

 

Mitral stenosis is usually a consequence of rheumatism acquired in childhood or adolescence, but sometimes it is congenital. In adult patients, the disease may result from degenerative changes and calcification of the valve ring. Rare cases of pathology are caused by damage after radiation therapy of thoracic organs. Isolated mitral stenosis occurs in up to 68% of cases of all mitral defects. Mitral stenosis develops very slowly, with clinical symptoms usually appearing 10 to 12 years after rheumatic heart disease. Gradually progressing heart failure develops.

Mitral stenosis as a complication of aortic valve replacement

 

Aortic valve replacement is the main treatment for aortic stenosis, a partial narrowing of the aortic valve. Clinical manifestation of aortic stenosis is marked dyspnea, pain in the chest during vigorous physical activity, and general fatigue. The most serious complication in patients with severe aortic narrowing is sudden cardiac death.

Transcatheter aortic valve surgery is the optimal surgical treatment for patients with aortic stenosis, who are unable to undergo the repair procedures. Endovascular prosthetics of the aortic valve are turned to in cases where standard "open" intervention is accompanied by potentially high risks. The intervention is an indication for patients with an aortic impairment who suffer from severe comorbidities like vascular lesions, chronic lung diseases, liver diseases, endocrine pathology, or oncology.

In such cases, the aortic valve replacement is performed without large surgical incisions through the femoral artery puncture under X-ray control, without artificial circulation and general anesthesia. One of the advantages of this transcatheter aortic valve surgery is the reduction of the side effects of sternotomy (sternum dissection) that include significant blood loss, pain syndrome during the hospital stay, risk of infection associated with the suture in the period after aortic replacement surgery. Thus, the use of endovascular technologies for aortic valve replacement significantly reduces the rehabilitation period of patients.

And these are the advantages of transcatheter aortic replacement procedure for aortic stenosis specifically, but how it affects the mitral valve is a whole other thing. See, the valves that the heart has are interconnected, and any surgical intervention performed on one of them is going to affect the other. Therefore, surgery conducted on the aortic valve for aortic stenosis puts other valves, including the mitral valve, at risk of developing various kinds of insufficiencies. This specifically regards patients undergoing treatment of aortic valve stenosis with aortic valve prosthetic repair who have previously undergone treatment of mitral valve defects. Considering that the mitral valve and aortic valve are located at the same side of the heart, an artificial aortic valve can cause the impaired functioning of the mitral valve.

Combined cardiac valve impairment

 

There is also combined cardiac impairment, which implies several valve conditions existing at the same time, like stenoses of different valves.

With valve insufficiency, the common mechanism of intracardiac hemodynamics disturbance is overloading of systolic regurgitation volume with further dilatation of heart chambers and gradual occurrence of heart failure due to decompensation.

Valve defects themselves, even with normal myocardial function, have a significant impact on the circulation. Aortic and mitral stenoses are typical examples of the limited heart functioning due to mechanical obstruction to the circulation.

Complications of mitral valve stenosis

 

Complications of mitral valve stenosis are often associated with abnormalities occurring in the left atrium due to its overload as a result of mitral valve deformation, which can lead to compensatory dilation of the left atrium with subsequent stasis in the circulation.

Heart failure develops gradually and is manifested by a diminished blood volume entering the systemic circulation, resulting in poor oxygen supply in the body, so the heart muscle cannot meet the needs of the body. As the left atrium works with a greater load, it hypertrophies, which in turn leads to subsequent accumulation of fluid in the lungs and development of shortness of breath. Gradually the load spreads to the right side of the heart, which leads to fluid accumulation and development of ascites.

Since the heart is hypertrophied due to the load resulting from stenosis, over time its compensatory ability deteriorates and heart failure develops. Patients usually complain about increased physical weakness, shortness of breath, and tachycardia during exercise, all of which being the signs of the heart gradually losing its ability to function properly.

Treatment principles in hospitals in Germany

 

The degree and duration of the medical care for disease depend on the severity of the features of the pathology the patient has, and the presence and continuity of its manifestation. Taking into consideration the above aspects, the specialists of the Department of Cardiology determine the required tactics of examination and therapy, give detailed instructions for the rehabilitation period (if any is needed), and further prevention of potentially problematic aftereffects. Timely medical care relieves the significant amount of manifestation of mitral valve stenosis and helps to prevent complications.

However, some patients require surgical intervention with common options of mitral valve plastic or prosthetic repair. Without contraindications, in the majority of cases, valve repair surgery tactics are given priority. The reason is that after such surgery the patient does not have to take lifetime courses of anticoagulant drugs. Repair surgery also reduces the risk of other heart diseases.

In all other cases, the mitral valve is replaced with a mechanical or biological prosthesis. Mechanical prostheses are obviously artificial to the body and can cause blood clotting disorders, so that is why patients who have undergone such a replacement surgery must continuously take anticoagulant drugs. Biological valves do not require any adjacent drug therapy. The main advantage of prosthetic treatment with biological valves is the absence of the need for continuous anticoagulant drugs, however, such valves need to be replaced after some time.

Surgical options for mitral valve stenosis

 

The main options for the surgery to treat mitral valve stenosis are mitral commissurotomy and valvuloplasty.

Commissurotomy is an intervention for mitral stenosis primarily caused by defects of a rheumatic nature. In this procedure, the commissures are manually cut by a doctor. The fused chordae papillary apparatus is separated, and the valve leaflets are freed from calcium outgrowth on its walls. The outgrowth is removed to eliminate the chances for thromboembolism formation.

Balloon valvuloplasty is one of the newest and already widely demanded techniques of minimally invasive therapy of cardiac valve defects. It is used in the treatment of both aortic and mitral stenosis. The therapy is performed with modern instruments and exclusively by experienced specialists of the Departments of Cardiology in hospitals in Germany, which ensures a high level of effectiveness and safety of valvuloplasty.

A procedure does not require a long recovery time. It is as safe as open-heart surgery, well-tolerated, and carries little risk of postoperative complications. The patient can be discharged from the hospital the very next day. The absence of general anesthesia deserves special attention. This fact also shortens the recovery period.

The recovery period after surgery

 

The patient is under constant cardiac monitoring and usually remains under supervision for 24-48 hours after surgery.

If mechanical circulatory support and inotropic agents (substances that support heart muscle contraction) were used during surgery, they are discontinued as valve function is restored. When bleeding from the chest wound stops, the drainage tubes are disconnected. To prevent infective endocarditis or to prevent attacks of rheumatic carditis, a course of antibiotics is prescribed.

If recovery proceeds normally, the patient is discharged from the hospital one week after conventional surgery. Upon discharge, the patient is given precise instructions about how to care for the wound and avoid infections, and they are given contact information for the attending physician and recommendations about when to visit the Department of Cardiology for wound care. Within three to four weeks after discharge, the patient should come in for a consultation with the attending physician. Thereafter, if no complications or subsequent symptoms have been observed, the patients are advised to see a specialist once a year to monitor the situation. After a complete recovery, the patient returns to the previous lifestyle with some restrictions.

Prognosis

 

The prognosis for most patients with mitral stenosis from the moment of the onset of clinical manifestation with appropriate and timely treatment averages is quite good.

However, some health conditions, for example, coronary sclerosis complicates the prognosis. 

Life expectancy in mitral stenosis depends to some extent on the functional state of the respiratory organs. Long-term blood stasis, hypertension of the circulation resulting in gas exchange disturbance in alveoli, and the decrease of lungs vital capacity. Sudden cardiac death in mitral stenosis does not occur.

Which hospitals in Germany choose for treatment?

 

The best hospitals for the treatment of mitral valve stenosis in Germany are considered to be:

  • University Hospital Oldenburg.
  • University Hospital Essen.
  • University Hospital Ulm.
  • University Hospital Frankfurt am Main.
  • University Hospital Tuebingen.

You are welcome to check out the profiles of the mentioned German hospitals on the Booking Health website.

The cost of treatment

 

Some people consider the cost of treatment in Germany relatively high. But here is what one pays for:

  • Experienced doctors. Specialists in hospitals in Germany are highly experienced and professional. They have the necessary knowledge and skills to perform surgical interventions.
  • Modern equipment. The use of top-class equipment and necessary instruments meeting the highest international standards ensures the quality of surgical treatment.
  • Safety and comfort of surgery. Specialists in Germany make sure that patients feel no discomfort. All necessary conditions are provided for this.

As for the surgical treatment, the cost of treatment with valvuloplasty starts at 5,074 EUR, and the cost of treatment with commissurotomy starts at 9,714 EUR.

The prices for diagnostics of mitral valve stenosis in Germany start at 488 EUR, and the prices for rehabilitation start at 566 EUR.

If you want to know the cost of treatment, the peculiarities of its performance, and preparation for it, just contact Booking Health using the request form on the website.

How to start treatment in Germany?

 

Starting the treatment in Germany is easy with Booking Health.

Booking Health prepares your medical documents, negotiates with the selected hospital, provides assistance with applying for a medical visa, and does everything in its power to ensure the quality of treatment.

Fill in the request form on the Booking Health website to get to know how to start your treatment in Germany.

Authors: Dr. Nadezhda IvanisovaDr. Farrukh Ahmed