Surgical treatment for coarctation of the aorta with subclavian flap aortoplasty in HELIOS Heart Surgery Clinic Karlsruhe

About the department

The Department of Cardiac Surgery at the HELIOS Heart Surgery Clinic Karlsruhe offers the full range of modern cardiovascular interventions for adult patients, with the exception of heart and lung transplantation. The department specializes in transcatheter aortic valve implantation (TAVI), heart valve reconstruction and replacement surgery, interventions for heart rhythm disturbances, aortic diseases, coronary artery bypass grafting and other surgical procedures. The department is a certified Center of Transcatheter Aortic Valve Implantation of the German Cardiac Society (DKG). Whenever possible, cardiac surgeons prefer sparing minimally invasive interventions, which are performed without thoracotomy. The department has five excellently equipped operating rooms, including a hybrid operating room. The team of the department's surgeons works in accordance with the current clinical protocols and observes modern hygiene and safety standards. In addition, the specialists of the medical facility take care of the maximum comfort of patients during the entire therapeutic process and devote enough time to personal communication with the patients and their relatives.

The department is headed by Prof. Dr. med. Uwe Mehlhorn. The specialist enjoys a reputation as one of the leading cardiac surgeons in Germany. He has long clinical experience and thousands of saved human lives. He is rightfully proud of many successful research projects and is regularly honored to speak at prestigious national and international conferences.

Of particular interest for the team of the department's cardiac surgeons is minimally invasive surgery. The range of surgical services in this field includes transcatheter aortic valve implantation (TAVI), minimally invasive interventions on the aortic, mitral and tricuspid valves, minimally invasive direct coronary artery bypass grafting and hybrid myocardial revascularization combined with percutaneous coronary angioplasty. Such operations are characterized by minimal trauma to the healthy tissues, since they eliminate the need for thoracotomy. The doctors use surgical access through a small incision in the groin or in the left side of the sternum. Minimally invasive interventions are an excellent alternative to classical cardiac surgery for high-risk patients (for example, elderly patients or patients with severe concomitant diseases). The operations are performed in a state-of-the-art hybrid operating room specially adapted for this type of intervention.

The department is often visited by patients with heart rhythm disturbances (arrhythmias). The first-line treatment is drug therapy, but if it does not ensure the desired result, the only option for the patient is surgery. Depending on the particular diagnosis and clinical indications, the surgeons implant a pacemaker or defibrillator. The specialists perform operations to implant classic pacemakers in patients with a low heart rate (bradycardia), pacemakers that synchronize the contraction of individual heart chambers (cardiac resynchronization therapy) and implantable cardioverter-defibrillators for ventricular fibrillation.

In addition, the department's cardiac surgeons have long experience in the surgical treatment of aortic aneurysms. They offer all modern methods for the treatment of this pathology. If the aneurysm is in the aortic arch, prosthetics (replacement of a part of the aorta) will be performed. If the aneurysm is in the abdominal or thoracic aorta, the department's surgeons mostly implant a hollow tube prosthesis (a stent). Aortic aneurysm surgery is performed using a heart-lung machine.

Other department's focuses are surgical treatment of congenital heart defects, heart valve reconstruction and replacement surgery, artificial heart (ventricular assist device) implantation for heart failure, coronary artery bypass grafting to restore normal blood flow in the coronary arteries, surgery to remove cardiac tumors (for example, atrial myxoma), etc.

For more than 25 years, the medical facility has been providing treatment to the patients, including those from other countries, providing them with the highest quality of medical services. The main task of the department's doctors is to offer each patient an individual and most sparing treatment. The cardiac surgeons use in their clinical practice only modern surgical techniques, which effectively eliminate heart dysfunctions.

The department's range of surgical services includes:

• Minimally invasive surgical interventions
  • Transfemoral and transapical catheter aortic valve implantation (TAVI)
  • Minimally invasive aortic valve surgery
  • Minimally invasive mitral and tricuspid valve surgery
  • Minimally invasive direct coronary artery bypass grafting
  • Hybrid myocardial revascularization combined with percutaneous coronary angioplasty
• Coronary artery bypass grafting
  • Total coronary artery bypass grafting using both internal thoracic arteries
  • Off-pump coronary artery bypass surgery (OPCAB)
  • Comprehensive coronary artery bypass grafting in recurrent coronary heart disease after previous surgery
• Heart valve surgery
  • Surgical repair of the mitral and tricuspid valve, including in the form of combined surgical interventions with coronary artery bypass grafting and simultaneous operations on several valves
  • Surgical aortic valve repair in combination with surgical treatment of aortic aneurysm (type A acute aortic dissection, Bentall procedure, David procedure)
  • Replacement of all heart valves using biological and mechanical prostheses, including in acute/chronic endocarditis
• Surgery for heart failure and heart rhythm disturbances
  • Implantation of pacemakers, implantable cardioverter-defibrillators (ICD), event recorders (heart rate recorders)
  • Cardiac resynchronization therapy (CRT)
  • Comprehensive revision interventions after implantation, including sepsis, with laser removal of electrodes
  • Implantation of devices for mechanical support of blood circulation (artificial heart ventricles – LVAD, RVAD, BiVAD) as a temporary measure prior to heart transplantation or as a permanent therapy
  • Round-the-clock extracorporeal life support (ECLS) and extracorporeal membrane oxygenation (ECMO) with mobile mini-devices of the artificial heart and lungs for the use out of the hospital in the patients with cardiogenic shock
• Thoracic aortic aneurysm surgery
  • Aortic aneurysm surgery (for example, supracommissural replacement of the ascending aorta, Bentall procedure, David procedure), also in combination with aortic valve reconstruction
  • Surgical treatment of acute aortic dissection type A (AADA)
  • Hybrid aortic arch surgery
• Surgical correction of heart defects in adults
  • Minimally invasive closure of persistent foramen ovale or atrial septal defect
  • Postinfarction ventricular septal defect closure
• Surgical removal of cardiac tumors
  • Removal of cardiac tumors (for example, atrial myxoma), including minimally invasive surgery 
• Atrial and pulmonary vein catheter ablation, including minimally invasive surgery
• Other medical services