Diagnosis of tricuspid valve stenosis in Hannover Medical School (MHH)

About the department

The Department of Adult and Pediatric Cardiothoracic Surgery, Vascular Surgery, Heart and Lung Transplantation at the Hannover Medical School offers the full range of services in these medical fields and ranks among the world's leading medical centers. It provides the effective surgical treatment of diseases of the heart, heart valves, congenital heart defects, pathologies of blood vessels and thoracic organs. The department specializes in the implantation of pacemakers, defibrillators, and mechanical circulatory support systems. In addition, the department is a renowned center for heart and lung transplantation, as well as combined heart-lung transplantation. The team of the department's surgeons annually performs about 2,000 operations using a heart-lung machine. The medical facility also performs more than 250 heart surgeries for children, about 120 lung transplantations and 30 heart transplantations every year. It is not surprising that performing so many complex operations, the department ranks among the best European Heart Surgery Centers. The department is headed by Prof. Dr. med. Arjang Ruhparwar.

The key to excellent treatment results, which the department has been showing over the years, is not only the high competence of doctors, state-of-the-art equipment and advanced surgical methods, but also active research activities. The medical facility ranks among the leading research centers in Europe, which carries out continuous work to improve the existing treatment methods in the field of cardiothoracic, vascular and transplant surgery, as well as develops and implements innovative therapeutic techniques.

Of particular interest in the field of cardiac surgery is the surgical treatment of heart valve diseases, coronary artery pathologies, as well as operations for the implantation of ventricular assist devices. Whenever possible, cardiac surgery is performed using minimally invasive surgical techniques, without thoracotomy. This innovative approach to treatment allows the patient to recover from surgery in the shortest possible time and avoid serious risks related to classical open surgery.

The department's pediatric cardiac surgeons deal with the treatment of congenital heart defects in children of all age groups. The department has more than 40 years of experience in this field, so surgeons have the necessary clinical skills to provide high-quality medical care to young patients with any cardiac diseases – from atrial septal defect to ventricular hypoplasia. The department also supervises adult patients with congenital heart defects.

The department's thoracic surgeons in collaboration with pulmonologists provide the surgical treatment of all benign and malignant diseases of the lungs, bronchi and trachea, thoracic wall and diaphragm. If lung cancer is diagnosed in a patient, the specialists from related medical disciplines are involved in the therapeutic process, who cooperatively develop the most effective and sparing treatment regimen. The specialists also have vast experience in surgery for thoracic wall deformities. The most common intervention in this area is the minimally invasive Nuss procedure to correct pectus excavatum. The operation has been performed in the department since 2014.

The department's doctors achieve excellent results in vascular surgery. Therapeutic options include both classic open surgery and modern endovascular interventions. The department regularly performs surgeries to treat carotid artery stenoses and occlusions, aortic reconstruction surgeries, bypass grafting, as well as decompression surgery for thoracic outlet syndrome. Vascular surgeons can be proud of their excellent results in the treatment of varicose veins and chronic venous insufficiency. The service range in the field of vascular surgery is complemented by percutaneous transluminal angioplasty, lysis therapy, implantation of port systems, and the formation of dialysis access.

An equally important area of the department's specialization is heart, lung, and heart-lung transplantation. The transplantation program in the department started back in 1983. Since then, the number of heart and lung transplantations, as well as simultaneous heart and lung transplantations has grown steadily. Today, the department is a leader in transplantation medicine in Europe. The survival rates of patients after lung transplantation reach 87% after 1 year and almost 50% after 10 years – the best results in the world. Both the pediatric lung transplantation program (more than 10 transplants per year) and the lung donation program introduced in 2012 are unique in Germany.

The department's range of medical services includes:

• Surgical treatment of heart valve pathologies
  • Surgery to replace and repair heart valves (especially mitral valve reconstruction and aortic valve reconstruction using the David procedure)
  • Implantation of a seamless heart valve
  • Implantation of a "growing" heart valve in children (tissue engineering)
  • Repeated prosthetic repair of the heart valve
  • Minimally invasive mitral valve surgery
  • Repeated interventions after previous cardiac surgery
  • Interventional aortic valve replacement (transapical / aortic access)
• Coronary surgery
  • Minimally invasive techniques, including revascularization on beating heart (for example, without the use of a heart-lung machine)
  • Total arterial coronary revascularization, the use of arterial grafts from the internal thoracic artery and radial artery
  • Coronary artery bypass grafting for acute myocardial infarction
  • Reconstruction for severe coronary artery lesions 
  • Treatment of secondary complications caused by ischemic heart disease (ventricular aneurysm, ventricular septal defect, heart failure)
  • Coronary surgery using modern perfusion systems (miniaturized heart-lung machine)
• Aortic surgery
  • All types of replacement and reconstruction of the aortic root, for example, Ross procedure and David procedure
  • Ascending aortic dissection
  • Treatment of thoracic, thoracoabdominal and abdominal aortic aneurysms using a heart lung-machine
  • Implantation of homografts (the patient's own blood vessels)
• Organ transplantation
  • Lung transplantation
  • Heart transplantation
  • Heart-lung transplantation
  • Implantation of mechanical circulatory support systems
• Vascular surgery
  • Reconstructive interventions on the arteries, for example, for carotid thromboembolism
  • Operations on supra-aortic vessels
  • Aortic replacement surgery
  • Reconstruction of pelvic and thigh veins (Y-prosthesis)
  • Renal artery bypass and visceral artery bypass grafting
  • Decompression procedures, for example, for thoracic outlet syndrome
  • Complex interventions for replacement of the vena cava in case of cancer
  • Vascular surgery in children
  • Treatment of infected vascular prostheses using cryopreserved human allografts (homografts) and surgery for relapses
  • Use of an extracorporeal perfusion method to protect organs, for example, in supra- and perirenal aortic aneurysms
  • Percutaneous transluminal coronary angioplasty (PTCA), implantation of peripheral and central stents (including stent implantation in the carotid artery, iliac artery recanalization)
  • Endovascular aortic stenting
  • Implantation of dialysis shunts
  • Implantation of permanent catheters
• Thoracic surgery
  • Resection of benign and malignant tumors of the thoracic organs, lungs and respiratory tract (bronchi, trachea)
  • Diagnostic interventions for the detection of lung diseases (mediastinoscopy, video-аssisted thoracoscopy)
  • Thymectomy (removal of thymus) in myasthenia gravis
  • Correction of thoracic deformities, such as pectus excavatum and pectus carinatum
  • Treatment of injuries of the thoracic organs and sternum (rib fractures, sternal instability)
  • Surgery for thoracic outlet syndrome (1st rib or cervical rib resection)
  • Sympathectomy for hyperhidrosis (increased sweating in the head, arms and hands)
  • Palliative care for patients with severe lung diseases
• Surgical treatment of congenital heart defects
  • Surgical correction of congenital heart defects in infants
  • Treatment of the hypoplastic left or right heart syndrome
  • Heart valve reconstructive surgery and aortic arch surgery
  • Late correction and treatment of recurrent, residual and accompanying defects in adults with congenital heart defects
  • Implantation of tissue-engineered heart valves
  • Implantation of pacemakers
  • Procedures to replace organ functions in cardiac and pulmonary failure (ECMO), artificial heart implantation 
  • Heart, lung transplantation and simultaneous heart and lung transplantation
• Other treatment methods