Department of Adult and Pediatric Cardiac Surgery - University Hospital of Ludwig Maximilian University of Munich

About the Department of Adult and Pediatric Cardiac Surgery at University Hospital of Ludwig Maximilian University of Munich

The Department of Adult and Pediatric Cardiac Surgery at the University Hospital of Ludwig Maximilian University of Munich offers all the possibilities of modern surgery for treating heart disease, including a heart transplant. The department's team of surgeons admits both adult patients and children. The department annually performs more than 3,500 operations, including minimally invasive ones. The most common diseases in the clinical practice of cardiac surgeons include heart failure, coronary artery disease, heart arrhythmias, and heart valve and aortic pathologies. The department's operating rooms have all the resources for efficient and safe heart surgery. The patients' health is in the safe hands of a highly qualified team of doctors and nursing staff, numbering more than 155 employees. The main task of surgeons is to provide an optimal treatment based on the very latest advances in modern medicine. At the same time, the specialists always show a humane attitude towards a patient, considering his individual needs and wishes. The Head Physician of the department is Prof. Dr. med. Christian Hagl.

One of the most demanded surgical procedures in the department is coronary artery bypass grafting. Such an operation is usually indicated for patients with severe coronary artery disease, in which the myocardium suffers from a lack of oxygen and nutrients. The goal of the surgical intervention is to create a new blood flow path around the affected artery. The department's cardiac surgeons perform coronary artery bypass grafting both with and without a heart-lung machine (on a beating heart). Open surgery with the use of a heart-lung machine is considered to be quite complex, since it requires a thoracotomy and a temporary cardiac arrest. The duration of this surgery is 3-5 hours. Cardiac surgeons try to perform coronary artery bypass grafting without connecting a patient to a heart-lung machine whenever possible, since the risks of such an intervention are quite low, and rehabilitation is much easier.

An integral part of the department's clinical practice is the surgical treatment of heart valve pathologies (stenosis and insufficiency). In appropriate clinical indications, the affected heart valve can be reconstructed, and in severe pathological changes, cardiac surgeons perform an operation to replace the valve with a prosthesis. The department's specialists use high-quality mechanical and biological prostheses. The optimal type of prosthesis is selected individually. Each of the prostheses has its own advantages and disadvantages: a mechanical prosthesis has a long service life (20-30 years), but patients with such a prosthesis need to take anticoagulants for life; when implanting a biological prosthesis, there is no need to take drugs for life, but this prosthesis cannot boast of a long-term service life (up to 15 years). Young patients are usually indicated for the implantation of a mechanical prosthesis, and the elderly have a biological one implanted.

The department's cardiac surgeons successfully perform operations for heart rhythm disturbances (arrhythmias). In many cases, arrhythmias are amenable to drug control, but if such a therapy is ineffective, the department's cardiac surgeons prescribe an operation for a patient. If the heart rate is low, a pacemaker implantation surgery is performed. If the patient's heart rate is too high, a defibrillator implantation is indicated. With more than 600 operations to implant pacemakers and defibrillators every year, the specialists of the medical facility have rich experience in this field. Cardiologists, including pediatric ones, are usually also involved in the therapeutic process. The department also pays particular attention to the replacement and removal of infected or damaged electrodes on pacemakers and defibrillators. Surgeons perform more than 120 such surgical interventions annually, which are highly complex operations. Atrial fibrillation (one of the most common heart rhythm disturbances) is often treated with radiofrequency ablation. The technique is minimally invasive and involves the use of catheter-based techniques. Radiofrequency ablation is performed jointly with cardiologists.

In the field of pediatric cardiac surgery, special attention is paid to the repair of congenital and acquired heart defects. Cardiac surgeons, together with pediatric cardiologists, offer expectant mothers the chance to undergo fetal echocardiography, which makes it possible to detect congenital heart pathology even in the womb (before the 20th week of pregnancy). After the baby is born, an echocardiogram is repeated. Heart catheterization procedures and CT or MRI scans can also be performed, after which the final decision is made on the surgical intervention. Pediatric cardiac surgeons often perform heart valve replacement interventions with homografts and Contegra valve conduits (mechanical valves are used very rarely). Surgical treatment of heart diseases in children is carried out in accordance with the current recommendations of professional societies and current clinical protocols.

The department's range of surgical options includes:

• Surgical treatment of coronary artery disease
  • Standard coronary artery bypass grafting with the use of a heart-lung machine
  • Coronary artery bypass grafting without the use of a heart-lung machine
  • Minimally invasive coronary artery bypass surgery
  • Jarvik 2000 left ventricular assist system implantation
  • Intra-aortic balloon counterpulsation
• Surgical treatment of heart valve pathologies
  • Aortic valve pathologies
    • Aortic valve surgical repair
    • Aortic valve replacement, including transcatheter aortic valve implantation (in collaboration with cardiologists)
  • Mitral valve pathologies
    • Mitral valve surgical repair
    • Mitral valve replacement
  • Tricuspid valve pathologies
    • Tricuspid valve surgical repair
    • Tricuspid valve replacement
  • Pulmonary valve pathologies
    • Pulmonary valve surgical repair
    • Pulmonary valve replacement
• Surgical treatment of end-stage heart failure
  • Triple-chambered pacemaker implantation for cardiac resynchronization therapy
  • Left ventricular assist device (LVAD) implantation
  • Extracorporeal membrane oxygenation (ECMO)
• Surgical treatment of types A and B aortic dissections (according to Stanford classification)
  • Open surgery
  • Endovascular surgery
• Surgical treatment of heart arrhythmias
  • Pacemaker implantation
  • Cardioverter-defibrillator implantation
  • Radiofrequency ablation
  • Care for patients with previously implanted pacemakers and defibrillators
• Surgical treatment of heart disease in children
  • Open and minimally invasive surgery for the repair of congenital and acquired heart defects
  • Palliative interventions for heart defects in children (for example, univentricular heart, atrioventricular canal defect, and tetralogy of Fallot)
• Heart transplant in adults and children, including combined heart-lung transplant
• Other diseases and treatment methods