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Aortic Valve Stenosis with Transcatheter Aortic Valve Implantation (TAVI) in Germany

University Hospital Essen

9.6/10
location_onGermany, Essen

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.

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University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Cardiothoracic Surgery

The Department of Cardiothoracic Surgery offers the full range of surgical treatment of diseases of the heart, lungs, thoracic organs and blood vessels. Medical care is provided 24 hours a day. The doctors of the department prefer an individual approach to each patient and take into account all his needs and wishes. In clinical practice, doctors apply both classic and innovative surgical techniques in order to achieve the best therapeutic results.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

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.

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

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.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

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.

University Hospital RWTH Aachen

9.5/10
location_onGermany, Aachen

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.

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

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.

University Hospital Bonn

9.2/10
location_onGermany, Bonn

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.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

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.

University Hospital Jena

8.9/10
location_onGermany, Jena

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.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Cardiothoracic Surgery

The Department of Cardiothoracic Surgery covers the entire range of top-class medical services in this field. Special attention is paid to minimally invasive operations, which, along with the optimal functional result, ensure minimal traumatization, fast recovery and the absence of a cosmetic defect. The optimal type of therapy is selected in collaboration with the specialists from all the necessary related disciplines and adapts to the specific clinical indications of the patient.

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

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.

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

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.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

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.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

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.

University Hospital Saarland Homburg

9.8/10
location_onGermany, Homburg

Department of Adult and Pediatric Cardiothoracic Surgery

The Department of Adult and Pediatric Cardiothoracic Surgery offers the full range of services in this medical field and specializes in providing top-class medical care to patients with diseases of the heart, lungs, and aorta. Cardiothoracic surgeons treat patients of all age groups, ranging from young children to the elderly. The primary focus of the doctors' work at the medical facility is the treatment of aortic and mitral valve regurgitation, with the specialists aiming to perform a reconstructive intervention rather than heart valve replacement surgery. Doctors have vast experience in coronary artery bypass grafting. The department is one of the few medical facilities of this kind in Germany, where doctors offer endarterectomy for chronic pulmonary embolism. The department has modern medical equipment and competent staff, which guarantees excellent medical care as well as a friendly and responsive attitude towards patients. The department performs more than 1,600 surgical interventions of varying complexity, and more than 2,200 patients receive medical care on an outpatient basis.

Heart valve diseases often remain undetected for a long time. They usually progress slowly due to the compensatory mechanisms of the heart. Even young patients can get heart valve diseases – for example, as a result of a bacterial disease or after a heart attack. Heart valve defects require medical attention and should be treated appropriately in order to prevent further damage to the heart muscle.

Overview

Heart valve diseases can be divided into stenosis and insufficiency. Valve stenosis is a narrowing of the heart valve due to the substitution with fibrous tissue or scarring. As a result, blood can no longer flow freely and the heart must work harder to pump it. Valve failure occurs when the valve no longer closes completely, so blood can flow back.

Aortic valve stenosis is a cardiovascular disease in which there is a narrowing of the lumen of the aorta in the area of the valve, which leads to a hampered outflow of blood from the left ventricle. It is often accompanied by reduced circulation in the coronary vessels that branch off from the aorta near it beginning.

The congenital form of the disease occurs with anomalies of prenatal development. Most often, congenital aortic valve stenosis is detected in patients younger than 30 years. As a rule, the acquired form of aortic valve stenosis occurs as a complication of rheumatism. Also, the causes include aortic atherosclerosis, Paget's disease, calcification of the aortic valve, infective endocarditis, systemic lupus erythematosus, and rheumatoid arthritis.

Types

There are several classifications of aortic valve stenosis in medicine, depending on the general state of the cardiovascular system, the location of the narrowed site, and the cause of the disease.

A combined form of aortic valve stenosis develops on the background of damage to other valves. It is often combined with aortic insufficiency and mitral stenosis (narrowing of the opening between the left chambers of the heart). An isolated form of aortic valve stenosis develops as an independent disease.

Depending on the localization of the area of narrowing, there are three forms of aortic valve stenosis:

  • Valvular aortic stenosis (diagnosed in more than 60% of patients)
  • Supravalvular aortic stenosis (diagnosed in up to 10% of all cases)
  • Subvalvular aortic stenosis (diagnosed in about 30% of all patients with this pathology)

By origin, rheumatic (develops after rheumatism) and non-rheumatic stenosis of the aortic valve are distinguished.

Causes

The onset of aortic valve stenosis may be connected with congenital anomalies. The most common cause of aortic valve stenosis is rheumatism. It leads to deformation and fusion of the valve leaflets, which contributes to the violation of blood flow.

Also, the risk of developing the disease increases with the following conditions:

  • Atherosclerosis (narrowing of the lumen of the vessel due to the deposition of fatty plaques on its walls)
  • Infective endocarditis (inflammation of the inner lining of the heart)
  • Connective tissue diseases (rheumatism, systemic lupus erythematosus)
  • Severe impairment of kidney function
  • Congenital heart anomalies
  • Arterial hypertension (high blood pressure)

The risk of developing pathology increases in people prone to smoking and drinking alcohol, as well as those who consume fatty and fried foods.

Symptoms

Depending on the degree of narrowing of the vessel lumen, aortic valve stenosis may be asymptomatic or manifest itself with a vivid clinical picture. At the initial stage of development, aortic valve stenosis is not accompanied by clinical manifestations. The first symptoms occur when the diameter of the aorta narrows by about 50%.

The patient may experience:

  • Shortness of breath (first after physical exertion, then at rest)
  • Weakness, fatigue
  • Dizziness
  • Muscle weakness

As the disease progresses, more severe signs of aortic valve stenosis appear:

  • Difficulty breathing, especially at night
  • Fainting
  • Intense pain in the heart region

In severe cases, the patient develops pulmonary edema, i.e. accumulation of fluid in the alveoli.

If the slightest disturbances in the cardiovascular system appear, it is important to visit a doctor as soon as possible. Only timely diagnosis will help doctors to administer an effective treatment for the pathology.

For many years, the pathology can stay asymptomatic. The development of clinical manifestations of aortic valve stenosis indicates an increased risk of complications. In this case, surgical treatment is often required. With the absence of therapy, the life expectancy of patients is about 2-5 years. If treatment is started timely, 85% of patients manage to overcome the 5-year survival period after a surgery. More than 70% of them can live for over 10 years.

Therefore, the prognosis for aortic valve stenosis is favorable only with the early and correct treatment. Otherwise, the disease is fatal.

Complications

At advanced stages, aortic valve stenosis can lead to the following consequences:

  • Infective endocarditis
  • Violation of coronary blood circulation, which leads to additional pathologies of the cardiovascular system
  • Arrhythmia (heart rhythm disorder)
  • Myocardial infarction (death of a part of the heart muscle)
  • Sudden cardiac death (occurs mainly in elderly patients)

Only a timely examination will help to avoid the development of such complications.

Diagnostics

To reveal aortic valve stenosis, the following diagnostic methods are used:

  • Anamnesis taking
  • Physical examination of the patient – listening to heart sounds, determining the boundaries of the organ
  • Electrocardiography (ECG)
  • Ultrasound scanning of the heart
  • Aortography (X-ray examination of the aorta with a contrast agent)

All diagnostic methods are selected for each patient individually.

Treatment

Treatment of severe aortic valve stenosis may be planned and urgent. Heart valve disease should be treated as early as possible, even if it does not cause any discomfort. The goal is to avoid permanent damage to the heart and prolong life.

Damage to the aortic valve is accompanied by the development of myocardial dysfunction and impaired systemic hemodynamics. The decompensation of the heart, which occurs over time, leads to the development of severe complications. Surgical replacement of the affected aortic valve allows normalizing the heart function, improving the patient's condition significantly, and increasing life expectancy.

In recent years, advances in heart surgery of defective valves have skyrocketed. And there is a lot of research in medicine that is ongoing and aimed at performing novel minimally invasive procedures.

Until now, open aortic valve implantation has been the standard of care. However, about one-third of patients with aortic valve stenosis are not candidates for such surgery due to the high risk of complications, both during the surgery and in the postoperative period. This is because aortic valve stenosis most often occurs in elderly people, who often have various concomitant diseases.

The situation in medicine has changed when transcatheter aortic valve implantation (TAVI) was introduced into clinical practice. One of the important advantages of this operation in comparison with traditional open aortic valve implantation is that this method of the treatment is low-traumatic, since the duration of TAVI procedures is shorter than with open surgery, and the postoperative period is much shorter as well.

Transcatheter aortic valve implantation (TAVI) is performed via access through the femoral artery and does not require any incisions, which significantly reduces the risk of complications. Transcatheter aortic valve implantation is performed in an equipped with X-ray operating room. Transcatheter aortic valve implantation does not require anesthesia, local anesthesia and sedation are sufficient. The doctor performs puncture and catheterization of the femoral artery. With the help of a special system of conductors and catheters, he reaches the chambers of the heart, i.e. the left ventricle and the aorta, through the coronary vessels. The position of the catheters is constantly monitored using fluoroscopy. By inflating a special balloon, the affected valve is pressed against the wall of the aorta. An artificial valve is installed in its place and immediately begins to function. On average, a patient stays in the department of cardiology for 2-3 days after transcatheter aortic valve implantation (TAVI).

Damage to the aortic valve apparatus, in particular stenosis and calcification of the leaflets, is one of the indications for implantation TAVI. A common "traditional" technique in medicine is the so-called open method. It requires opening the chest cavity – thoracotomy — and connecting the patient to a heart-lung machine. The most modern technique in medicine for the treatment of aortic valve stenosis is a unique minimally invasive surgical technique – TAVI (transcatheter aortic valve implantation).

The main advantages of the implantation TAVI technique are minimization of surgical trauma and blood loss, shorter duration of the intervention, as well as the absence of the need to connect a patient to the heart-lung machine. Transcatheter aortic valve implantation is most preferable for elderly patients and people with concomitant cardiac disorders. Currently, implantation TAVI is carried out in the leading foreign cardiology clinics.

TAVI is recommended for all patients with aortic valve stenosis and appropriate clinical indications. These minimally invasive surgical interventions can be carried out in patients with concomitant pathology of the cardiovascular system and elderly patients.

Regardless of whether a biological or artificial heart valve, there is always strict prevention of endocarditis after surgery. Scars cause blood turbulence in the heart. This increases the risk of bacteria deposition and inflammation, which can be fatal. Therefore, a prophylactic antibiotic should be taken before surgery, oral procedures (such as dental prophylaxis), and bacterial infections.

Like any other surgery, cardiovascular surgery is associated with certain risks. When planning the surgical treatment, the patient's age and medical history are taken into account. Before deciding on the method of treatment, the doctor always discusses the risks of the operation with the patient. The cardiologists believe that the benefit to the patient should outweigh the potential risks associated with the surgery.

Where can I undergo treatment in Germany with transcatheter aortic valve implantation (TAVI)?

Medical tourism is becoming more and more popular these days, as medicine in Germany often ensures a much better quality of transcatheter aortic valve implantation (TAVI).

The following hospitals show the best success rates in transcatheter aortic valve implantation (TAVI):

  1. University Hospital Essen
  2. University Hospital Oldenburg
  3. University Hospital Ulm
  4. University Hospital Frankfurt am Main
  5. University Hospital Tuebingen

You can find more information about the foreing medicine and European hospitals on the Booking Health website.

The cost of treatment in Germany with transcatheter aortic valve implantation (TAVI)

The prices in hospitals listed on the Booking Health website are relatively low. With Booking Health, you can undergo treatment in Germany with transcatheter aortic valve implantation (TAVI) at an affordable price.

The cost of treatment varies, as the prices depend on the hospital, the specifics of the disease, and the complexity of its treatment.

The cost of treatment of aortic valve stenosis with transcatheter aortic valve implantation (TAVI) in Germany starts with a price of 32,824 EUR.

You might want to know the cost of treatment with additional medical procedures and follow-up care, as the ultimate cost of treatment in Germany 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 treatment in Germany with transcatheter aortic valve implantation (TAVI)?

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 transcatheter aortic valve implantation (TAVI) 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 in Germany with transcatheter aortic valve implantation (TAVI). We provide our services so that you can undergo transcatheter aortic valve implantation (TAVI) of high quality.

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.




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