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Cardiosurgery: Aortic valve stenosis — Aortic valve replacement. Treatment

Aortic valve stenosis (AVS) is one of the most common heart diseases characterized by a decrease in diameter of the aortic orifice, resulting in increased resistance to the blood flow from the left ventricle into the aorta. The AVS prevalence rate is about 25% of all heart defects, but it is usually accompanied by the other valve defects.

Conservative Treatment of Aortic Stenosis

Upon asymptomatic progression, the special treatment is usually not required. The patient is recommended to pass regular check-ups by a cardiologist and adjust his/her lifestyle. Upon moderate AVS decompensation, the drugs supporting the heart work and metabolism are prescribed:

  • diuretics;
  • cardiac glycosides;
  • antiarrhythmics;
  • antithrombotic agents;
  • metabolic drugs;
  • beta-blockers.

Surgical Correction of Aortic Stenosis

The indications for AVS surgical treatment are determined individually, taking into account the intensity of symptoms and stenosis progression. In the preoperative period, the patient is prescribed a course of conservative therapy for prevention of operative and post-operative complications.

There are several methods of surgical correction of the aortic stenosis. The best option is chosen depending on severity of the clinical picture and preservation of the valve structures.

  • Balloon dilatation is performed via a minimally invasive access through the femoral artery. A special probe is advanced through the vessels to the valve, which is expanded due to baloon inflation. The surgeon’s actions are controlled by X-ray methods and echocardiography.
  • Valve plastics is indicated in the absence of gross structural abnormalities in the valve. The surgery requires an open access and use of cardiopulmonary bypass.
  • Aortic valve replacement is the most common surgery for aortic stenosis. The surgery involves removal of the valve components and prosthesis implantation. Traditional prosthetics involves sternotomy and cardiopulmonary bypass connection.
  • Transcatheter aortic valve replacement is a new technique, which allows implanting the prosthesis with a minimal trauma. In European clinics, the combined prostheses made of materials of biological and synthetic origin are used. A special implanting system has a self-expanding structure, due to which the prosthesis is firmly fixed in the right place.

Subject to adequate preparation and selection of the optimal surgical technique, the long-term positive results are observed in 80-85% of the operated patients.

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HELIOS Clinic for Heart Surgery Karlsruhe

9.9/10 from17 Votes
location_onGermany, Karlsruhe
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Department of Cardiac Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #50049

The Department of Cardiac Surgery annually treats more than 700 patients with aortic valve stenosis. Surgeons’ qualification allows to replace the valve with a high quality mechanical or biological prosthesis with complete restoration of normal blood flow in the aorta. The team of surgeons under the direction of Prof. Dr. med. U. Mehlhorn pays special attention to the individual choice of an effective treatment method.

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Charite University Hospital Berlin

9/10 from95 Votes
location_onGermany, Berlin
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Department of Cardiovascular Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #106775

The Department of Cardiovascular Surgery at the University Hospital Charite is located at the Campus Charite Mitte. It offers treatment of all congenital and acquired cardiovascular diseases.

University Hospital Oldenburg

10/10 from33 Votes
location_onGermany, Oldenburg

Department of Cardiac Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #361508

The Department of Cardiac Surgery offers the full range of services in this medical field. Many heart operations are performed minimally invasively, which has a positive effect on wound healing, the patient experiences less pain, and the period of hospitalization is significantly reduced.

University Hospital Muenster

9.8/10 from78 Votes
location_onGermany, Muenster

Department of Congenital (CHD) and Acquired Heart Defects

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #139925

The Department of Congenital (CHD) and Acquired Heart Defects at the University Hospital Muenster is the first Center of Excellence specializing in the treatment of adults with congenital and acquired heart defects on both outpatient and inpatient basis. The second focus is the treatment of acquired defects (e. g.

University Hospital Frankfurt am Main

10/10 from97 Votes
location_onGermany, Frankfurt am Main
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Department of Cardiac, Thoracic and Vascular Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #74739

According to the Focus magazine rating of 2017, the Department of Cardiac, Thoracic and Vascular Surgery ranks among the top German departments specializing in cardiac surgery! The department is a distinguished institution in this field of medicine.

HELIOS Clinic Krefeld

9.7/10 from38 Votes
location_onGermany, Krefeld

Department of Adult and Pediatric Cardiovascular Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #383035

The Department of Adult and Pediatric Cardiovascular Surgery offers the full range of services in this medical focus. The department specializes in heart valves surgery, coronary artery bypass grafting, surgical treatment of cardiac arrhythmias and heart failure.

Hirslanden Clinic Aarau

9.9/10 from15 Votes
location_onSwitzerland, Aarau
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Department of Cardiosurgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #89863

The cardiac surgery department of the Hirslanden clinic Aarau was rebuilt since Prof. Dr. med. Thierry Carrel and PD Dr. med Lars Englberger worked here. Both of them are recognized cardiac experts. Prof. Carrel is the director at Inselspital and PD Dr.

HELIOS University Hospital Wuppertal

9.8/10 from42 Votes
location_onGermany, Wuppertal

Department of Cardiac Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #393376

The Department of Cardiac Surgery treats all heart diseases in adults. In addition, the department specializes in mitral valve reconstruction with the help of minimally invasive techniques, as well as in the surgical treatment of thoracic aortic aneurysm.

Rambam Health Care Campus Haifa

9.8/10 from23 Votes
location_onIsrael, Haifa

Department of Cardiac Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #327459

The Department of Cardiac Surgery at Rambam Health Care Campus specializes in performing open and closed heart operations. There is offered a broad spectrum of surgical heart procedures, while the most common of these are coronary artery bypass surgery, valvular heart surgery and a combination of the two.

University Hospital Essen

9.6/10 from23 Votes
location_onGermany, Essen

Department of Thoracic and Cardiovascular Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #292046

The Department of Thoracic and Cardiovascular Surgery at the Essen University Hospital offers the full range of services in the treatment of heart diseases, requiring surgery, including transplant of chest organs, heart and lung support systems and aortic surgery.

University Hospital RWTH Aachen

9.5/10 from41 Votes
location_onGermany, Aachen
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Department of Thoracic, Vascular Surgery and Cardiac Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #106295

The Department of Thoracic and Cardiovascular Surgery offers the entire spectrum of cardiothoracic surgery, including heart transplantation and the use of artificial heart systems. A special focus is on the development and the use of minimally invasive surgical techniques.

University Hospital Duesseldorf

9.5/10 from71 Votes
location_onGermany, Duesseldorf
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Department of Cardiovascular and Thoracic Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #82695

The Department of Cardiovascular Surgery at the University Hospital Dusseldorf provides the whole range of cardiovascular medicine at the university level. The Department has a long and successful history. Since 1938 more than 50,000 cadiac surgeries were performed here.

University Hospital Bonn

9.2/10 from150 Votes
location_onGermany, Bonn
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Department of Cardiac Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #88305

The Department of Cardiac Surgery offers the complete spectrum of cardiac surgery services except heart transplantation.

University Hospital Tuebingen

9.2/10 from55 Votes
location_onGermany, Tuebingen
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Department of Thoracic and Cardiovascular Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #137443

The range of surgical services of the Department of Thoracic and Cardiovascular Surgery at the University Hospital Tubingen covers all surgical and interventional operations in the corresponding fields up to the transplant surgery.

University Hospital Hamburg-Eppendorf

9.2/10 from92 Votes
location_onGermany, Hamburg

Department of Cardiovascular Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #298634

The Department of Cardiovascular Surgery at the University Medical Center Hamburg-Eppendorf covers the full range of heart diseases requiring surgery – from children with congenital defects up to older patients.

Academic Hospital Bogenhausen Munich

9.2/10 from43 Votes
location_onGermany, Munich

Department of Cardiac Surgery

Treatment of aortic valve stenosis with valve replacement (biological or mechanical) #154655

Performing annually more than 1000 surgeries on the heart, the department of cardiac surgery belongs to the largest centers of cardiac surgery in Munich. Here, the whole range of cardiovascular diseases is treated in adult patients, from emergency cases to heart attack.




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