Bypass Graft Repair for Aortic Coarctation
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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.
Aortic coarctation is one of the most common heart defects, accounting for up to 7% of all cases. The disease is often severe, causing critical hemodynamic disorders in patients shortly after birth. If hemodynamic compensation occurs, severe complications will develop after the age of 20-30 years. Every case of coarctation of the aorta requires treatment to restore normal circulation. The earlier it is performed, the better the results. You are welcome to use the Booking Health service to undergo your treatment abroad or find out the cost of treatment at a hospital abroad. On our website, you can compare prices at different hospitals and get services for organizing your trip to a foreign hospital.
Content
- What is aortic coarctation?
- What is a bypass graft repair for aortic coarctation?
- When can a bypass graft repair for aortic coarctation be performed?
- How is a bypass graft repair for aortic coarctation performed?
- Benefits of a bypass graft repair for hemodynamic restoration in aortic coarctation
- Where to undergo your aortic coarctation treatment?
What is aortic coarctation?
Coarctation of the aorta is the narrowing of this blood vessel. This can be localized anywhere but is most often found in the ductus arteriosus.
The disease is characterized by severely impaired hemodynamics, since too little blood passes through the narrowed section of the aorta into the systemic circulation. Over time, a partial recovery of hemodynamics occurs due to the expansion of coronary collaterals, which are bypass routes for blood flow. However, comprehensive recovery does not occur, so all patients with coarctation, without exception, need surgery.
If left untreated, coarctation causes severe complications. These may be ventricular dysfunction, brain aneurysms, severe arterial hypertension, or early coronary heart disease.
What is a bypass graft repair for aortic coarctation?
Bypass grafting is an operation to form a bypass, which is an additional blood vessel through which blood flows around the area of narrowing of the aorta. Doctors perform blood vessel grafting from another part of the body. During the grafting procedure, the blood vessel is fixed above the narrowing with one end and below the narrowing with the other.
At hospitals abroad, such a grafting procedure can be performed without the use of a heart-lung machine. During the bypass graft repair, it also does not matter what condition the aorta and its arch are in or whether there are adhesions in the thoracic cavity because the operation can still be performed successfully.
A bypass graft repair was first performed in 1973. The technique was developed to reduce the risk of complications. This surgery is indeed one of the safest for a patient. In the original version of the surgical intervention for the treatment of coarctation, the bypass started from the aortic arch and flowed into the descending aorta. This bypass graft repair is called an aorto-aortic bypass.
Based on the results of the blood vessel grafting and the formation of an aorto-aortic bypass, complete hemodynamic recovery occurs. After recovery, patients can lead a full and active life without any restrictions. The quality of life increases and its duration increases due to the prevention of complications of aortic coarctation and improved control of arterial hypertension.
When can a bypass graft repair for aortic coarctation be performed?
A bypass graft repair to restore hemodynamics is not very common in hospitals abroad. Basically, this operation is performed on adult patients with coarctation.
Bypass grafting is not one of the main methods of restoring hemodynamics in patients with aortic coarctation. Doctors at most hospitals prefer to perform end-to-end anastomosis, aortic replacement surgery, or balloon angioplasty with stenting. However, in some cases, an aorto-aortic bypass is still used. Basically, blood vessel grafting to form a bypass blood flow path is performed in the following cases:
Recurrent coarctations of the aorta. If a patient has previously undergone surgical treatment but has experienced recurrent blood vessel narrowing, a bypass graft repair is performed.
Adhesions at the site of the surgical intervention. Adhesions may develop both after operations for heart defects and after any other surgical interventions. They interfere with the necessary manipulations. Therefore, in such a case, an aorto-aortic bypass is a technically simpler solution to restore blood flow, as well as more successful.
An atypical localization of the narrowed site. For example, if the coarctation area is located in the descending thoracic aorta or in the abdominal aorta.
A rather long length of the narrowed site. A bypass graft repair may be performed as an alternative to an aortic prosthetic repair. However, prosthetic repair surgery is more common.
A high risk of brain damage. A bypass graft repair can be performed without clamping the carotid arteries or using a heart-lung machine. Therefore, the technique is suitable for the treatment of patients in whom prolonged depletion of the cerebral blood flow is unacceptable due to the high risk of cerebral complications.
How is a bypass graft repair for aortic coarctation performed?
The operation is performed using open techniques. Surgical approaches may be different. Surgeons may make an incision in the center of the chest, on the lateral surface of the chest on the left, or on the right. Most often, a right-sided thoracotomy is performed when an incision is made between the ribs on the right.
A bypass graft repair may be performed with or without the use of a heart-lung machine. In general, surgeons prefer to perform the operation without connecting a patient to the heart-lung machine to reduce the risk of complications. The possibility of avoiding its use is one of the main advantages of bypass grafting as compared to other operations for aortic coarctation repair.
The incision is usually made in the fifth intercostal space. A doctor opens the pleura, retracts the lung upward and anteriorly, and highlights a segment of the aorta about 10 centimeters long. The right intercostal arteries are ligated. Doctors implant the lower end of the vascular prosthesis and check its tightness. The lung is then retracted down and back, the pericardium (pericardial sac) is dissected, the ascending aorta is isolated, and the upper part of the graft is placed.
Upon completion of the operation, the clamps are removed, and blood flow in the aorta is restored. Doctors close a surgical wound by suturing it. For several days, tubes remain in the wound to drain fluid from the pleural and pericardial cavities.
Benefits of a bypass graft repair for hemodynamic restoration in aortic coarctation
The bypass grafting technique is less common as compared to other hemodynamic restoration surgeries for aortic coarctation. However, it has benefits that allow this treatment option to remain in the arsenal of surgeons for half a century. The main ones are:
- because aortic parietal pressing is not required, cerebral circulation is not impaired (there is a low risk of neurological disorders after surgery);
- the aorta is not dissected in the area of degeneratively altered walls;
- there is not even a minimal likelihood of some complications that are inherent in other types of operations, such as damage to the recurrent laryngeal nerve, intercostal arteries, or lungs;
- the absence of complications from the spinal cord;
- the operation can be performed without the use of a heart-lung machine, so complications associated with its use (systemic inflammation or damage to blood cells) do not develop;
- a less traumatic surgical approach shortens patients' recovery time and makes the postoperative period easier;
- during a bypass graft repair to restore blood flow in coarctation, simultaneous release of the esophagus and trachea in the case of their compression can be performed, if required.
Where to undergo your aortic coarctation treatment?
You can undergo your treatment abroad. There are a few reasons for you to go abroad. These are the following:
- in developed countries, operations for aortic coarctation are effective and safe;
- hospitals abroad have state-of-the-art equipment;
- doctors use the latest modifications of surgeries;
- operations are performed through minimally traumatic surgical approaches and without a heart-lung machine;
- successful interventions are performed even in complex cases: in significant degenerative changes in the aorta, concomitant aortic arch hypoplasia, adhesions in the chest cavity, and secondary pathologies of the cardiovascular system;
- after the operation, you will be able to undergo full rehabilitation to return to your normal life in a short time.
You are welcome to use the Booking Health service to undergo your treatment abroad. On our website, you can see the cost of treatment, compare prices, and choose a medical care program. When you make an appointment at the hospital through Booking Health, the cost of treatment abroad will be lower for you. Prices are reduced due to the absence of additional taxes for foreign patients. In addition, you can be sure that the initial cost of treatment will not increase after the start of your medical care program. You will receive insurance that will cover unexpected medical expenses.
The Booking Health specialists will organize your treatment abroad. We will contact the hospital administration, make an appointment on your preferred dates, translate and send your medical documents to the hospital, and book the nearest hotel and airline tickets. Our company's employees will meet you at the airport and take you to the hospital by car. After the completion of your treatment abroad and recovery, a return transfer from the hospital to the airport will be organized.
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:
European Society of Cardiology
