Aortic Valve Insufficiency (AVI) — Aortic Valve Repair: treatment in the Best Hospitals of 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.
The human heart has four valves, through each of which blood flows in a specific direction. The valves allow blood to flow in the right direction and prevent it from flowing back.
Content
- Overview
- Causes and risk factors
- Symptoms
- Diagnostics
- Treatment
- Prognosis
- Where can I undergo aortic valve repair treatment in Germany?
- The cost of treatment in Germany with aortic valve repair
- How can I undergo aortic valve repair treatment in Germany?
Overview
When a valve cannot close properly or does not open completely due to certain diseases, like for example valve stenosis, heart valve disease is diagnosed. Depending on the severity of diseases and on their cause, heart failure may develop gradually or rapidly, with corresponding medical manifestations.
Aortic valve insufficiency refers to a heart defect in which damage of the aortic valve prevents the aortic valve from closing completely. This causes a circulatory disorder.
During the ventricular systole, blood goes from the left ventricle and enters other vessels along the aorta. In the absence of pathological diseases in this area, the aortic valve flaps are connected fully, and this excludes the return of blood back. The blood moves along the aorta, making its full cycle. But if such pathology as aortic valve insufficiency develops, normal blood flow is disturbed, the aortic valve does not completely close the aortic opening and some of the blood returns to the left ventricle. The left ventricle also receives blood from the left atrium at the same time. As a result, the larger volume of blood accumulates in the left ventricle. The left ventricle needs to cope with a large volume of blood, making great efforts to maintain blood coronary flow. Over time, as a result of this increased load, the heart muscle becomes hypertrophied. Besides, against the background of aortic valve insufficiency, the heart itself does not receive sufficient nutrition due to impaired coronary blood flow. This further aggravates the quality of the heart work.
Insufficiency of the aortic valve can be an isolated defect, or it can occur in different combinations with other heart diseases.
Causes and risk factors
The following health conditions can be the causes of aortic valve insufficiency:
- Rheumatism or inflammation of the connective tissues of the mitral and aortic valves
- Degenerative changes in the valves of the heart (calcification, Marfan syndrome)
- Infectious diseases of the heart muscle: endocarditis, myocarditis
- Complications of heart diseases (post-infarction conditions, excessive expansion of the valves as a result of pulmonary hypertension)
Symptoms
Given the great compensatory capabilities of the myocardium, the disease may be asymptomatic for a long time. Even during a physical exertion, a person may not experience symptoms immediately.
Without proper treatment, the progression of violations of coronary and cerebral disorders leads to the development of the first symptoms in the form of dizziness, weakness, fatigue, and high heart rate. Aortic valve insufficiency is manifested by tachycardia, felt at rest, and symptoms worsen after physical exertion. Pallor is noted. Shortness of breath develops, as well as angina attacks.
A person with aortic valve insufficiency can have external medical manifestations of the pathology. The patient can see the pulsation of the cervical vessels and the head might be shaking along with the pulse.
When measuring blood pressure, and increased systolic pressure is detected, but diastolic pressure is always decreased. With such diseases, blood pressure always changes and the condition is poorly controlled by the medications intake.
During the heart auscultation, there is a weakening of the first tone at the apex, and a weakening of the second tone over the aorta (up to complete disappearance in the severe destruction of the valve leaflets). A soft blowing diastolic heart murmur appears in the third intercostal space on the left and above the aorta. It's auscultated more clearly when the patient exhales completely and holds his breath.
Changes in blood flow occurring against the background of the medical condition cause enlargement of the left ventricle and may eventually lead to mitral valve insufficiency. This will manifest itself with a systolic heart murmur. Flint's diastolic heart murmur appears less often. Sometimes, with this medical condition noises can be heard when auscultating the femoral artery.
A severe complication of the aortic valve insufficiency is pulmonary edema, as a manifestation of heart failure and heart rhythm disturbance – ventricular extrasystole.
Diagnostics
First of all, the doctor may think about the presence of aortic valve insufficiency based on the results of the medical examination of the patient. The manifestations of this pathology have their own peculiarities, which are revealed externally and during the auscultation. As mentioned above, typical symptoms appear at a certain stage of the disease development.
The medical diagnosis is confirmed after carrying out diagnostic procedures.
Echocardiography can detect signs of this defect in the form of backflow of blood, increased work of the muscle wall of the left ventricle during systole, and tremor of the mitral valve when blood fills the left ventricle.
A phonocardiogram reveals changes in tones and noises that identify aortic valve insufficiency.
ECG and X-ray examination of the heart may not detect changes for a long time. They are found at the later stages, when left ventricular hypertrophy develops.
Treatment
The aortic valve insufficiency is usually a mechanical problem that does not respond well enough to medicines. The only exceptions when medicines can be effective are cases of acute infectious diseases of the heart valves, for example, infective endocarditis, in which the further development of valvular insufficiency can be stopped only with the help of a large dose of medicines.
With medicines, the feeling of discomfort caused by a defect in the heart valve can be eliminated. For example, medicines are used in shortness of breath. ACE inhibitors, AT-antagonists and beta-blockers are used in weakening of the pumping function of the heart muscle and an increase of the atria volume. Such medicines as beta-blockers or drugs from the glycoside group are prescribed to slow down the heart rate in atrial fibrillation. Medicines with a vitamin K-antagonist are additionally used to prevent thromboembolism.
Surgical treatments of valve insufficiency involve either valve repair or valve replacement.
Mitral valve replacement, for example, is a very common surgery. A new non-surgical method of treatment, i.e. the percutaneous mitral valve repair using the MitraClip system, is currently recognized and approved for medical use as an effective method of treating diseases of the mitral valve. It is used successfully in the treatments of mitral valve insufficiency. The MitraClip method is an important therapeutic option for selected high-risk patients with congestive heart failure.
Aortic valve replacement surgery, on the other hand, uses either an artificial valve or a prosthesis made of biological material. A valve created in a high-tech laboratory is used to replace the aortic valve. Installation of such a prosthesis is an extremely responsible task. It can only be performed by an experienced surgeon. The surgery requires serious preparation, and the recovery period also requires effort of the patient and healthcare professionals.
Aortic valve replacement can be performed in two ways:
- Open heart surgery
- Minimally invasive method
Modern cardiac surgery actively uses methods that allow carrying out the aortic valve replacement surgery without incision of the chest. Surgery without an incision will be more expensive than open surgery. However, this approach reduces the risks and facilitates the recovery period.
An alternative to open-heart surgery to replace the aortic valve is the transcatheter aortic valve replacement. With a catheter, the prosthetic heart valve is passed through the vascular system, usually through the femoral artery, or transapically – directly into the heart cavity, up to the aortic valve, where it is positioned. Access can be created through an artery in the shoulder or leg, using a catheter. Local or general anesthesia is required. The total time for the endovascular aortic valve replacement surgery is about one to one and a half hours.
The cost of treatment with open aortic valve replacement surgery is lower than with minimally invasive surgery. During valve replacement with open surgery, the patient is connected to an artificial circulatory system, a heart-lung machine. The risk for the patient is slightly higher than with the alternative method, but there is no risk of deformation of the conducting vessels.
Three types of the artificial valve used in aortic valve replacement are usually available at the department of cardiology.
- Biological valve.
Sometimes it is possible to reconstruct a new valve from the patient's own tissues. Such a valve will serve for about 10-15 years, after which the aortic valve replacement surgery will need to be repeated. This is due to the gradual degradation of the reconstructed valve, its inevitable degenerative changes. With this approach, medicine needs to be taken only for the first six months after surgery.
- Mechanical valve.
Such a valve is manufactured in a laboratory and requires the constant intake of medicine (for the patient's entire life). Such prostheses are installed mainly in young patients.
- Donor valve.
This option is used only in separate cases since there is a risk of rejection of donor tissues by the patient's body. The outcome of aortic valve replacement with such an artificial valve is difficult to predict; the possibility of complications cannot be assessed in advance. For the valve to remain viable, doctors need to carry out therapy that suppresses the recipient's immunity. As with the installation of an artificial valve, the patient needs a lifelong intake of medicines to exclude the possibility of thrombus formation.
The recovery period is also the important stage, which has its own peculiarities. During the first days after aortic valve replacement, physical activity and psycho-emotional overload are prohibited. Follow-up should last for at least three years after the surgery. Professional athletes can only return to training in few years. Taking medicine prescribed by a doctor is a prerequisite. It is also very important to check regularly the state of the body, and monitor possible concomitant diseases. The artificial valve itself is not going to affect the patient's health in the future.
Prognosis
The medical prognosis for aortic valve insufficiency depends, first of all, on the degree of damage to the heart muscle. A neglected disease can lead to myocardial weakness, heart failure and, ultimately, death.
Where can I undergo aortic valve repair treatment in Germany?
Medical tourism is becoming more and more popular these days, as a treatment in Germany often ensures a much better quality of aortic valve repair.
The following hospitals show the best success rates in aortic valve repair in Germany:
- University Hospital Essen
- University Hospital Oldenburg
- University Hospital Frankfurt am Main
- University Hospital Tuebingen
- University Hospital RWTH Aachen
You can find more information about the hospitals on the Booking Health website.
The cost of treatment in Germany with aortic valve repair
The prices in European hospitals listed on the Booking Health website are relatively low. With Booking Health, you can undergo treatment in Germany with aortic valve repair at an affordable price.
The cost of treatment in Germany varies, as the prices depend on the hospital, the specifics of the disease, and the complexity of its treatment.
The average cost of treatment with aortic valve repair in Germany is 20,442 EUR – 35,459 EUR.
You might want to consider the prices of additional medical procedures and follow-up care, e.g. rehabilitation after aortic valve replacement in Germany. Therefore, the ultimate cost of treatment with aortic valve repair may differ from the initial price.
To find out information about the overall cost of treatment in Germany, contact us by leaving the request on the Booking Health website.
How can I undergo aortic valve repair treatment in Germany?
It is not easy to self-organize any treatment abroad. It requires certain knowledge and expertise. Thus, it is safer, easier, and less stressful to use the services of a medical tourism agency.
As the largest and most transparent medical tourism agency in the world, Booking Health has up-to-date information about aortic valve repair in the best European hospitals. We will help you select the right medical center taking into account your wishes for treatment.
We want to help you and take on all the troubles. You can be free of unnecessary stress, while Booking Health takes care of all organizational issues regarding the treatment with aortic valve repair. We provide our services so that you can undergo aortic valve repair safely and successfully.
Medical tourism can be easy! All you need to do is to leave a request on the Booking Health website, and our manager will contact you shortly.
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!
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