Aortic Valve Insufficiency (AVI) with Aortic Valve Replacement 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 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 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 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
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 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 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 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 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.
The aortic valve can rarely be repaired. Doctors typically perform replacement surgery in both cases of aortic valve stenosis and insufficiency. Valve replacement is an open surgical procedure, which is not safe, so it is better to undergo your surgery in a good hospital to avoid any complications. You can get medical care abroad. You are welcome to visit the Booking Health website to find out the cost of treatment in Germany and compare the prices of treatment at different Cardiovascular Surgery Centers.
Content
- What is aortic valve insufficiency (AVI)?
- Indications for surgery to treat aortic valve insufficiency
- How is surgery for aortic valve insufficiency performed?
- Benefits of treatment in Germany for aortic valve insufficiency
- Organization of treatment in Germany for aortic valve insufficiency
What is aortic valve insufficiency (AVI)?
There are two types of blood circulation circles in the human body, namely large and small ones. The large circle begins in the left ventricle, from where blood enters the aorta through the aortic valve.
The valve is needed so that the blood flows only in one direction and does not return to the heart. When the heart contracts, blood is ejected into the aorta, at which point the valve is open. When the heart relaxes, the valve closes, preventing blood from flowing back into the left ventricle.
But if the patient's aorta becomes too wide or the heart valve leaflets are damaged, the aortic opening does not close completely. As a result, during the period of relaxation of the heart, part of the blood returns back to the left ventricle, overloading it. This phenomenon is called valvular insufficiency or regurgitation.
The greater the severity of the failure, the more blood returns and the greater the load on the heart. As a result, the heart gradually changes as the left ventricle expands, which can eventually lead to the development of heart failure. Valvular heart disease should therefore be timely treated to avoid this. You can completely get rid of this condition with the help of surgery.
Indications for surgery to treat aortic valve insufficiency
Aortic valve replacement is considered the main treatment option for aortic valve insufficiency (AVI). The operation is, however, not performed on patients immediately after the detection of the disease. If a patient does not have any symptoms and a mild form of aortic insufficiency is diagnosed, patients are treated with medicines, such as beta blockers, ACE inhibitors, and vasodilators.
Conservative treatment, including drugs and non-drug procedures, does not affect the prognosis of aortic valve insufficiency. Medicines only temporarily compensate for hemodynamic disorders.
Aortic valve replacement surgery may be indicated for patients with the following conditions:
- severe aortic valve insufficiency, regardless of the patient's symptoms and left ventricular function;
- asymptomatic aortic regurgitation in the case of impaired function of the left ventricle (ejection fraction less than 50% at rest);
- the presence of aortic regurgitation in patients who are scheduled for other cardiac surgery (coronary artery bypass grafting, surgical aortic interventions, or surgery on other heart valves); aortic valve replacement can be performed concurrently with the main surgical procedure in this case;
- significant dilatation (expansion) of the left ventricle with an end-systolic dimension of 55 mm or an end-diastolic diameter of 75 mm;
- expansion of the aortic root up to 55 mm in any patient;
- expansion of the aortic root up to 50 mm in patients with Marfan's syndrome;
- expansion of the ascending aorta up to 45 mm in patients with Marfan syndrome and in the presence of risk factors in the patient.
The risk factors that are taken into account when determining indications for aortic valve replacement are a rapid increase in the diameter of the aorta (2 mm per year or more), planning a pregnancy, or a burdened family history (if there is information about cases of severe aortic valve insufficiency in the patient's relatives).
How is surgery for aortic valve insufficiency performed?
Aortic valve replacement is performed during open surgery using a heart-lung machine. A doctor places an artificial heart valve inside the aorta, which can be mechanical or biological. Heart valve replacement can solve the problem of both aortic valve stenosis and aortic valve insufficiency.
Aortic regurgitation is usually of rheumatic origin. In the anamnesis of patients, there is almost always information about previous rheumatic fever. This means that:
- most patients are young and middle-aged people;
- most patients have heart valves other than the aortic valve that are also damaged.
Due to these circumstances, surgery typically includes not only aortic valve replacement but also the repair or replacement of other heart valves.
The type of artificial aortic valve chosen by patients is influenced by their age. In Germany, healthcare professionals prefer to implant mechanical prostheses in patients under the age of 60-65. With many shortcomings, they last longer than bioprostheses, which wear out over time, and on average, after 10 years, a person needs a second operation to replace the prosthesis. If a mechanical artificial aortic valve is implanted, it can serve for decades without requiring any repeated replacement surgery. Such a heart valve is usually enough for the patient's entire life.
At the same time, the mechanical artificial aortic valve has disadvantages. These are the following:
- worse hemodynamics;
- patients' physical activity levels are lower;
- limited opportunities for physical labor and sports;
- blood clots are more likely to form;
- patients have to take anticoagulants for life after their surgery;
- if the regimen of taking anticoagulants is impaired or insufficient laboratory control is provided, the risk of complications increases.
Because of these shortcomings, biological heart valves are implanted in the elderly. They do not last as long, but anticoagulants only need to be taken for 3 months, and the heart function of patients after such an operation is better. After a while, the heart valve degrades, but it can be replaced. Repeated heart valve replacement surgery is often performed using a minimally invasive procedure through blood vessels in the groin rather than through a chest incision.
Benefits of treatment in Germany for aortic valve insufficiency
If you have aortic valve insufficiency (AVI), you can undergo your treatment in Germany. In German hospitals, the operation is performed by experienced and highly qualified cardiac surgeons. Many doctors are highly reputable not only in Germany but also far beyond its borders.
The benefits of treatment in Germany for foreign patients include the following:
- there are the most modern procedures and operations available;
- German hospitals have state-of-the-art equipment;
- reliable results from aortic valve replacement;
- doctors can concurrently perform not only aortic valve replacement, but also the replacement or repair of other heart valves in one operation;
- simultaneous treatment of valvular heart disease and other pathologies is possible;
- a low risk of complications;
- high-quality postoperative care and rehabilitation of patients;
- a relatively low cost of treatment in Germany when compared with other developed countries.
Organization of treatment in Germany for aortic valve insufficiency
You are welcome to use the Booking Health website to undergo your treatment in Germany. On our website, you can get information about the cost of treatment in Germany, compare prices in different German hospitals, and select the most suitable medical care program.
Please leave your request on the Booking Health website to get a consultation. Our specialists will provide you with additional information about hospitals and doctors, help you choose a German hospital that specializes in aortic surgery and demonstrates the best results in the treatment of aortic valve insufficiency (AVI).
When you choose a treatment program through the Booking Health service, the cost of treatment in Germany will be lower for you than if you seek medical attention directly from a German hospital. Prices will be reduced due to the absence of increased taxes for foreign patients.
The Booking Health staff assists patients in organizing their trips to Germany for treatment. Our company's specialists will contact the administration of the German hospital and make an appointment for your preferred dates. They will also translate your medical documents into German, book a hotel room and airline tickets, meet you at the airport in Germany, and take you to the hospital by car. After the heart valve replacement, the company's employees will translate information on recommendations for further treatment into your language, keep in touch with the hospital, and provide remote medical consultations for 3 months. Whenever required, our company will take care of buying medicines in Germany and forwarding them to your native country.
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
