Resection With End-to-end Anastomosis for Aortic Coarctation treatment 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.
Aortic coarctation is one of the most common heart defects, accounting for up to 7% of all cases. Many treatment methods for this disease have been developed. Historically, the first, and still commonly used, method is coarctation resection with end-to-end anastomosis. This surgical treatment option is primarily used in children, including newborns. To avoid exposing the child to unnecessary risks, you can opt to undergo this surgery in Germany. Even the most complex types of heart disease are successfully eliminated in this country. You are welcome to use the Booking Health service to find out the cost of treatment in Germany and get services for organizing your trip abroad.
Content
- What is aortic coarctation?
- The essence of the treatment method for aortic coarctation
- Who may be a candidate for resection with end-to-end anastomosis for aortic coarctation?
- How is surgery for aortic coarctation performed?
- Why to undergo your surgical treatment for aortic coarctation in Germany?
What is aortic coarctation?
Coarctation of the aorta is a localized narrowing of a blood vessel, usually of small extent. This can be located in any part of the thoracic or abdominal aorta, but most patients have it localized in the area of the arterial duct. Its tissue, which grows to close the duct shortly after birth, is thought to be the cause of the narrowing of the aorta.
Coarctation of the aorta is often combined with aortic arch hypoplasia (underdevelopment). The condition can also be combined with hypoplastic left heart syndrome or congenital mitral and aortic stenosis.
In newborns with coarctation of the aorta, poor feeding, insufficient weight gain, and physical developmental delays are noted. Doctors listen to heart murmurs, and a weak pulsation is noted on the blood vessels of the legs. Over time, hemodynamics may improve due to the formation of coronary collaterals, which are blood flow pathways that bypass the narrowed area. This blood supply is, however, not enough to fully compensate for hemodynamics. The lower part of the patient's body lags behind in development compared to the upper. In the third or fourth decade of life, severe complications may develop, such as severe arterial hypertension, ventricular dysfunction, aortic aneurysms or dissections, and coronary heart disease.
The essence of the treatment method for aortic coarctation
There is a narrowed area in the aorta. This fragment of the aorta can be removed and the ends sutured. This technique is called end-to-end anastomosis. It is the simplest and, at the same time, very effective, especially in newborns.
End-to-end anastomosis is historically the first procedure to repair aortic coarctation. Today, it remains the main method of surgical treatment for heart disease in newborns, as it provides a low risk of recurrent coarctation of the aorta.
Coarctation of the aorta is one of the first heart defects that doctors learned to eliminate. The first successful operation was performed in Sweden. This was completed by Crafoord in 1944. After 9 years, doctors successfully operated on the baby for the first time. Surgeons applied a simple circular anastomosis. The problem with the first operations was the high rate of recurrence of the disease.
In 1977, the technique of the operation was improved. Amato proposed a technique called extended anastomosis. Following this, a modification of the operation appeared in 1987, which was proposed by Elliott, calling it a radically extended anastomosis.
Who may be a candidate for resection with end-to-end anastomosis for aortic coarctation?
Resection with end-to-end anastomosis for aortic coarctation is used in newborns and is their method of first choice. It is much more complicated to perform this surgery in adult patients because the aortic wall is sclerotic, often with calcification (deposition of calcium salts). The sutures erupt even under slight tension.
Therefore, the younger the patient, the more likely they are to be treated with end-to-end anastomosis. The older the person, the less often this technique is used, but sometimes it can be used in adolescents and adults.
How is surgery for aortic coarctation performed?
The operation is performed through a chest incision in the fourth intercostal space. Doctors remove part of the aorta and suture the ends together to keep the blood vessel intact. The aorta is clamped, but the patency of the subclavian artery is maintained to ensure collateral blood flow. The surgical intervention is performed using a heart-lung machine.
End-to-end anastomosis can be performed when the edges of the aorta diverge after removal of its section by no more than 3-4 cm, although in children, some doctors apply an anastomosis even with a divergence of up to 5 cm due to the mobilization of the aortic arch and subclavian artery. The anastomosis must be expanded using various surgical techniques to fit the normal aortic diameter. The anterior wall of the anastomosis is usually sutured with a U-shaped suture and the posterior wall with a blanket suture.
The advantage of the surgical treatment of coarctation is its physiology. The pathological segment of the aorta is completely removed during the surgery. As a result, the tissues no longer grow, and recurrent coarctation occurs very rarely. The anastomosis may grow with the child, though in some children, the aorta in the operated area may become narrower than the adjacent sections of the blood vessel.
Why to undergo your surgical treatment for aortic coarctation in Germany?
Doctors at German hospitals perform the surgical repair of aortic coarctation efficiently and safely. It is best to travel to Germany to ensure good long-term results, a low risk of complications, and the avoidance of future revision surgery. Treatment at German hospitals has the following benefits:
- state-of-the-art equipment;
- highly qualified cardiac surgeons with high authority far beyond the borders of Germany;
- new modifications of operations for surgical repair of aortic coarctation;
- successful interventions in patients of any age, including newborns and premature babies weighing less than 2 kg;
- even complex operations in the case of a significant extension of the coarctation area, aortic arch hypoplasia, or hypoplastic left heart syndrome are effective;
- if a patient has additional heart defects, these can be simultaneously eliminated in patients weighing more than 1.5 kg;
- restoration of coarctation of the aorta with a minimal risk of complications;
- high-quality postoperative care for patients and full rehabilitation.
You are welcome to use the Booking Health service to find out the cost of treatment in Germany, compare prices at different German hospitals, and make your treatment appointment at the best price. When you make your appointment through Booking Health, the cost of treatment in Germany will be lower for you than if you contact a German hospital directly. The price is reduced due to the lack of additional taxes for foreign patients. The initial cost of treatment in Germany will not increase for you, even if there is a need for additional procedures, as your insurance will cover the extra costs.
The Booking Health specialists will take care of all the arrangements for your trip to the German hospital. We will select a hospital that specializes in the surgical treatment of coarctation of the aorta and whose doctors perform resection with end-to-end anastomosis with the best results. Our company's employees will contact the hospital administration and schedule an appointment for your preferred dates. They will also book a room in the nearest hotel, purchase airline tickets, and translate your medical documents. Our company's employees will meet you at the airport and take you to the hospital by car. After the completion of your surgical treatment and recovery, they will take care of a return transfer from the hospital to the airport.
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
