Surgical Correction of Partial Anomalous Pulmonary Venous Connection in Germany
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Department of Cardiothoracic Surgery
According to the Focus magazine, the Department of Cardiothoracic Surgery ranks among the top German medical facilities specializing in the surgical treatment of diseases of the cardiovascular system and lung cancer! The department offers the full range of surgical services for the treatment of diseases of the cardiovascular system, respiratory tract, including heart and lung transplantation, artificial heart implantation. The therapeutic options include aortic surgery, coronary artery bypass grafting, transplantation surgery, surgical treatment of heart rhythm disorders (arrhythmias), minimally invasive surgery, surgical treatment of the heart valves, including reconstructive interventions. All operations are performed using state-of-the-art technology and in accordance with the current recommendations of professional societies.
Department of Cardiac Surgery
The Department of Cardiac Surgery provides a full range of surgical treatment in its area of specialization. Special emphasis is placed on heart valve repair and replacement surgery, coronary artery bypass grafting, thoracic aortic surgery, adult congenital and acquired heart disease surgery, pacemaker and defibrillator implantation, and artificial heart implantation for severe heart failure. Many heart operations are performed using minimally invasive techniques, which has a positive effect on the healing of the surgical wound. Minimally invasive cardiac procedures also reduce surgical risks and contribute to a rapid recovery of the patient in the postoperative period. Surgical treatment of cardiac pathologies is performed in advanced operating rooms equipped with the latest technology. The cardiac surgeons of the department successfully perform routine and complex surgical procedures, saving the lives of thousands of patients. The specialists work in accordance with current clinical protocols and follow the recommendations of the German Society for Thoracic and Cardiovascular Surgery (DGTHG).
Department of Cardiothoracic Surgery and Vascular Surgery
The Department of Cardiothoracic Surgery and Vascular Surgery provides effective surgical treatment for diseases of the heart, respiratory system, and blood vessels. The team of cardiac surgeons operates on patients with heart valve pathologies, coronary heart disease, heart failure, and heart rhythm disturbances. In the field of thoracic surgery, the key focus is on the surgical removal of lung tumors and lung metastases. The specialists in this area also perform surgery to repair chest wall deformities. In the field of vascular surgery, interventions for abdominal and thoracic aortic aneurysms are most often performed here. The department's vascular surgeons are also exceptionally competent in the treatment of peripheral occlusive arterial disease. A great advantage for the department's patients is that almost all surgical interventions are performed using minimally invasive techniques, so there is no need for a long postoperative recovery. The department's operating rooms are equipped with state-of-the-art technology. This allows for effective and safe treatment. The priority is always personalized medical care for patients.
Department of Cardiothoracic Surgery
According to the Focus magazine, the Department of Cardiothoracic Surgery ranks among the top German medical institutions specializing in the surgical treatment of heart diseases! The department offers the full range of first-class medical care for patients with diseases of the heart and thoracic organs that require surgical treatment. The availability in the department of advanced technical base allows for the most sparing treatment and minimally invasive surgery. The main focuses of clinical practice include coronary artery bypass grafting, modern procedures for heart valve reconstruction and replacement, treatment of diseases of the thoracic aorta, as well as treatment of heart failure by implanting an artificial heart.
Department of Adult and Pediatric Cardiothoracic Surgery
According to the Focus magazine, the Department of Adult and Pediatric Cardiothoracic Surgery is included in the ranking of the top German departments specializing in the surgical treatment of cardiovascular diseases! The department offers the full range of treatment of various diseases of the heart, blood vessels, organs of the respiratory system in adults and children. As part of the German Heart Competence Centre Tuebingen, the department is distinguished by the outstanding quality of medical care, competent specialists, as well as high-tech equipment of the latest generation.
Department of Cardiothoracic Surgery
According to the Focus magazine, the Department of Cardiothoracic Surgery ranks among the top medical facilities in the field of its specialization! The department offers all options of modern surgery for the treatment of diseases of the cardiovascular system and thoracic organs. The department widely uses modern minimally invasive techniques, which are considered the gold standard of surgery. Since its founding in 1976, the department has performed more than 40,000 open heart interventions. The department's surgeons also have vast experience in the field of implantation of the artificial heart and mechanical heart support systems. All operations are carried out in strict accordance with the protocols of professional societies.
Department of Cardiac Surgery
According to the Focus magazine, the Department of Cardiac Surgery ranks among the top German departments specializing in cardiac surgery! The department offers the full range of surgical interventions for the treatment of cardiac pathologies. The main priorities of the department include aortic surgery, heart transplantation, minimally invasive bypass grafting and heart valve surgery. It performs more than 2,500 surgical interventions every year. In especially complex clinical cases, all necessary specialists from the related fields are involved.
Department of Cardiac Surgery
According to the Focus magazine, the Department of Cardiac Surgery ranks among the top German departments specializing in the surgical treatment of heart diseases! The department offers the full range of modern surgical interventions for the treatment of diseases of the heart, coronary vessels and thoracic aorta (with the exception of transplantation of the thoracic organs). An excellently trained team of specialists and state-of-the-art technologies guarantee the best medical care adapted to the individual needs and wishes of patients.
Department of Adult and Pediatric Cardiothoracic Surgery
According to the Focus magazine, the Department of Adult and Pediatric Cardiothoracic Surgery is included in the ranking of the top departments in Germany specializing in the surgical treatment of diseases of the cardiovascular system! The department offers the surgical treatment of all congenital and acquired heart diseases in adulthood, including heart transplantation, as well as the treatment of respiratory diseases in adults and children. It performs more than 2,000 interventions on the heart and about 600 operations on the lungs every year.
Department of Cardiac Surgery and Heart Transplantation
According to the Focus magazine, the Department of Cardiac Surgery and Heart Transplantation ranks among the top German departments specializing in heart interventions! The department offers the full range of surgical treatment for cardiac pathologies of varying severity. A large number of the operations performed in the department are coronary artery bypass grafting and heart valve interventions, which are most often performed using minimally invasive techniques. The team of the department's surgeons is proud of their high success rates in surgical treatment and the prestigious quality certificates of the German Cardiac Society in the field of transcatheter aortic valve implantation (TAVI) and heart failure treatment. In addition, the medical facility enjoys the status of one of the best in the international medical arena for heart transplantation and the implantation of mechanical hemodynamic heart support systems. The department provides medical care in accordance with the very latest standards and offers the highest possible safety for patients. The surgical treatment is accurately planned and, if possible, operations are performed using sparing surgical techniques, without thoracotomy.
Department of Cardiothoracic Surgery
According to the Focus magazine, the Department of Cardiothoracic Surgery ranks among the top medical facilities of this kind in Germany! The department offers the full range of surgical treatment of diseases of the cardiovascular system and thoracic organs in adults. Of particular interest is sparing minimally invasive surgery, particularly, heart valve interventions and coronary artery bypass grafting. Such interventions are carried out using the innovative da Vinci surgical system. The video-assisted thoracic surgical methods are widely used in the surgical treatment of thoracic diseases as well. All the department's specialists have excellent qualifications and vast clinical experience, which in combination with the cutting-edge technologies allows doctors to achieve the outstanding treatment results.
Department of Cardiac Surgery
The Department of Cardiac Surgery specializes in a full range of cardiac surgical procedures. The medical facility performs operations for ischemic heart disease, valvular heart disease, arrhythmias, heart failure, aortic aneurysms, and aortic dissections. The department's cardiac surgeons have successful experience implanting mechanical circulatory support systems in patients with heart failure: Impella®, ProtekDuo®, and LVAD devices are implanted here. Of particular interest is minimally invasive surgery, which, in addition to an optimal functional outcome, ensures minimal trauma rate, rapid recovery, and the absence of cosmetic defects. In cooperation with interventional cardiologists, the department's surgeons also perform hybrid heart operations, combining catheter-based and classical surgical techniques. The department has the prestigious DIN EN ISO 9001:2015 certificate, given only to the best clinics with exceptional quality of medical services. The department also has the status of a national Heart Failure Center, certified by the German Cardiac Society (DGK) and the German Society for Thoracic and Cardiovascular Surgery (DGTHG).
Department of Cardiac Surgery
According to the Focus magazine, the Department of Cardiac Surgery ranks among the top German medical facilities specializing in the surgical treatment of cardiovascular diseases! The department offers the full service range in the field of cardiac surgery. Despite the fact that the department has long traditions, it has the reputation of one of the most high-tech Cardiology Centers in Europe. The clinical practice involves the use of achievements of modern surgery, particularly, minimally invasive and catheter techniques. Thus, cardiac surgeons achieve excellent results and at the same time guarantee the most sparing treatment and fast recovery for the patient.
Department of Adult and Pediatric Cardiothoracic Surgery
According to the Focus magazine, the Department of Adult and Pediatric Cardiothoracic Surgery ranks among the top German departments specializing in the surgical treatment of diseases of the cardiovascular system! The department offers the full range of surgical treatment of diseases of the heart, lungs, and other thoracic organs. The department has a long and successful history. It has performed more than 50,000 heart surgeries since 1938. The first open-heart surgery under hypothermia, the first heart valve replacement surgery, as well as the first pacemaker and cardioverter-defibrillator implantations in Germany should be mentioned among the department’s achievements.
Department of Adult and Pediatric Cardiac Surgery
The Department of Adult and Pediatric Cardiac Surgery 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.
Department of Congenital and Acquired Heart Defects, Heart Valve Diseases
The Department of Congenital and Acquired Heart Defects, Heart Valve Diseases offers the full range of diagnostics, outpatient and inpatient treatment of these diseases. The department became the first Center of Excellence in Germany in the field of its specialization and annually treats a large number of native patients and patients from other countries of the world. The department has a wide range of diagnostic options, as well as doctors have vast experience in catheter interventions. The department's medical team makes every effort in order to provide the first-class medical care adapted to individual needs. At the same time, important attention is paid to the psychosocial support of patients.
An anomalous pulmonary venous connection is a heart disease with a disturbed arrangement of the great (main) blood vessels. An anomalous pulmonary venous connection may be total or partial. The total form of this defect is a severe condition that, in its natural course, leads to the death of an infant already in the first year of life, while the partial form proceeds much more mildly and sometimes without any clinical manifestations but still requires treatment because it will inevitably cause complications in the future. You can undergo your treatment for this heart disease in Germany. Germany is a country offering advanced medicine, so you can expect good results after surgery. You can find out the cost of treatment in Germany and compare prices at different specialized hospitals on the Booking Health website.
Content
- Description of the disease: a partial anomalous pulmonary venous connection
- Who may need treatment for a partial anomalous pulmonary venous connection?
- How is surgical treatment for a partial anomalous pulmonary venous connection performed?
- Results of treatment in Germany for a partial anomalous pulmonary venous connection
- Where to have your partial anomalous pulmonary venous connection treatment?
Description of the disease: a partial anomalous pulmonary venous connection
The essence of this heart disease is that parts of the veins, which normally should carry oxygenated blood from the lungs, abnormally enter the venous part of the heart, or systemic veins. As a result, the blood returns back to the lungs instead of carrying oxygen to the tissues throughout the body.
Normally, arterial blood from the lungs enters the heart through the pulmonary veins. Most people have four such veins. The pulmonary veins normally enter the left atrium. If some of them open into any other cavities of the heart or blood vessels, such a pulmonary venous drainage is called anomalous. The more veins that connect incorrectly, the worse the patient's health condition, and the farther from the heart the pathological veins are, the more complex it is for doctors to repair a congenital anatomical defect.
Based on where the pulmonary veins flow, the following options for their anomalous connection are possible:
- a supracardiac anomalous pulmonary venous connection is a connection to the left brachiocephalic veins, superior vena cava, or its branches (the most common type of the disease that develops in 80% of patients);
- a cardiac anomalous pulmonary venous connection is a connection to the right atrium or coronary sinus;
- an infracardiac anomalous pulmonary venous connection is a connection to the inferior vena cava or its branches;
- a mixed anomalous pulmonary venous connection is a combination of the three options above.
Who may need treatment for a partial anomalous pulmonary venous connection?
Treatment is required for all patients with an established diagnosis of a partial anomalous pulmonary venous connection. It does not matter if they have any symptoms of the disease. With poor hemodynamic parameters and severe symptoms, surgery can be performed on a child during the first year of life. If there are no symptoms of the disease, the surgical repair will be performed until the age of 3-4 years.
Surgical treatment for an asymptomatic course of the pathological pulmonary venous drainage is performed to prevent late complications, including:
- right heart failure;
- atrial fibrillation;
- pulmonary hypertension.
It is important to perform treatment before these complications develop because myocardial changes may be irreversible. After the operation, they no longer progress, but complete regression does not occur either. There will be no health consequences if treatment is received on time. Such patients potentially have the same life expectancy as children who have never had heart defects. They will not require any revision interventions or procedures for the treatment of anomalous pulmonary venous connections in the future.
How is surgical treatment for a partial anomalous pulmonary venous connection performed?
The operation is performed on an open heart under general anesthesia using a heart-lung machine. The incision is usually made in the very center of the sternum. There are many types of surgical procedures. The choice of repair technique is determined by the characteristics of a partial anomalous pulmonary venous connection, since there are a huge number of anatomical variants of this heart disease. The types of operations to reconnect the pulmonary veins to the left atrium (their normal anatomical position) include the following:
- "intra-atrial" repair;
- transplantation of a collector of pathologically connected pulmonary veins into the left atrium or a normally connecting pulmonary vein;
- the Warden procedure, sometimes with replacement surgery of the superior vena cava;
- "single-patch" butterfly-shaped patch technique;
- the De Leon technique (in the case of connecting the pulmonary veins to the superior vena cava);
- the "growing heart" technique, which is used for a high confluence of pathological connections.
New types of operations are available in Germany that allow for a complete restoration of hemodynamics with a partial anomalous pulmonary venous connection. The results of surgery are preserved throughout life. Most patients will never need revision surgery for their congenital heart disease.
The best hospitals in Germany perform not only classical open but also minimally invasive robot-assisted surgeries using the da Vinci surgical system. This is an advanced technique that allows doctors to perform repair surgery more safely for a patient, with a lower trauma rate, and a relatively fast postoperative recovery. Small incisions are made in the intercostal spaces: the second, fifth, and seventh. The integrity of the sternum is preserved, which is very important for the healing of the surgical wound and maintaining the stability of the chest.
Mini-thoracotomy operations are sometimes performed by German doctors. These can be performed if the pulmonary veins of the left lung connect to the coronary sinus.
Results of treatment in Germany for a partial anomalous pulmonary venous connection
Surgical interventions to treat anomalous pulmonary venous connections in Germany give excellent results and rarely lead to any complications. The lethality of patients is very low and depends not so much on the characteristics of the disease as on the skills of the doctors. On average, around the world, it is 1-2%. In advanced Cardiac Surgery Centers in Germany, the mortality rate of patients is several times lower and amounts to tenths of a percent.
The results of surgical treatment of partial anomalous pulmonary venous connections in Germany are good even in patients with complex types of this heart disease. Doctors are able to completely restore hemodynamics once and for all. A complete recovery usually occurs within a year. After 12 months, 85% of patients have no symptoms from the cardiovascular system.
Residual symptoms or an incomplete restoration of hemodynamics may only occur in the following two cases:
- an error on the part of the surgeon;
- delayed seeking medical help after the development of irreversible changes in the myocardium.
Complications include anastomotic thrombosis, sinus node lesions, the development of arrhythmias, and sinoatrial node cutting.
Where to have your partial anomalous pulmonary venous connection treatment?
You can undergo your treatment in Germany. German hospitals have state-of-the-art equipment. German cardiac surgeons are considered among the best in the world and successfully perform even the most complex operations for an anomalous pulmonary venous drainage.
There are a few reasons for you to undergo your treatment in Germany. These are the following:
- a low patient mortality rate;
- a low risk of complications;
- reliable results that last forever;
- a minimal likelihood of needing any revision surgery, even in the distant future;
- the best German hospitals perform robot-assisted operations, which are less traumatic as compared to standard interventions;
- successful performance of even complex operations, for example, for infracardiac or mixed types of an anomalous pulmonary venous drainage;
- successful and safe repair of the defect at any age, including in infants.
You are welcome to use the Booking Health service to find out the cost of treatment in Germany and choose a medical care program at one of the specialized hospitals at the best price. The website presents the best hospitals in Germany. When you make your appointment at the medical center through Booking Health, the prices will be lower. The cost of treatment will be reduced due to the absence of increased taxes for foreign patients.
The Booking Health specialists will take care of arranging your treatment in Germany. We will contact the hospital administration, make an appointment on your preferred dates, and translate your medical documents into German. We will also book a hotel in Germany and airline tickets for you, meet you at the airport, and take you to the hospital by car. You will be accompanied by an interpreter at the hospital, and for any household or organizational issues, you can always contact your personal coordinator.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
ECR - European Cardiology Review
