Surgical treatment With the Heart-lung Machine for Congenital and Acquired Heart Defects 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 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.
Doctors treat most congenital and acquired heart defects with open-heart surgery. The heart is stopped for a while, and the functions of the heart and lungs are taken over by a heart-lung machine. The device saturates the blood with oxygen and pumps it through the patient's blood vessels. If you need surgery to repair a heart defect, you can go to Germany for surgical treatment. In this country, it will be safe with reliable results.
Content
- Who may need treatment of congenital and acquired heart defects with the use of a heart-lung machine?
- What is a heart-lung machine?
- How is a heart-lung machine connected for congenital and acquired heart defects?
- Where to have your treatment for congenital and acquired heart defects?
Who may need treatment of congenital and acquired heart defects with the use of a heart-lung machine?
In Germany, many operations for the treatment of congenital and acquired heart defects are performed using a heart-lung machine. Heart-lung machines are usually used during open-heart procedures. As a rule, the use of a heart-lung machine implies cardioplegia, in which the heart stops and relaxes. Less commonly, surgery is performed on a beating heart, despite the use of a heart-lung machine.
The following acquired heart defects can be treated with open-heart surgery using a heart-lung machine:
- aortic valve stenosis or insufficiency;
- mitral valve stenosis or insufficiency;
- tricuspid valve insufficiency or stenosis;
- pulmonary valve regurgitation or stenosis.
Patients do not always require surgery using a heart-lung machine. Whenever possible, doctors strive to solve the problem using minimally invasive techniques. In Germany, most surgeries for aortic valve stenosis and many surgeries for mitral valve regurgitation are performed using endovascular techniques (from inside the blood vessels) or through short chest incisions. When several heart valves are damaged, when stenosis is combined with insufficiency, and in patients from a low surgical risk group, open operations with heart-lung machines are mainly performed.
Congenital heart defects, in which surgical interventions with the use of a heart-lung machine are performed in Germany, include the following:
- tetralogy of Fallot;
- Eisenmenger syndrome;
- anomalous pulmonary venous connection;
- congenital heart valve stenosis or insufficiency;
- coarctation of the aorta;
- transposition of the great vessels.
At the same time, for the treatment of congenital heart defects in Germany, minimally invasive procedures are increasingly being used instead of traumatic operations with heart-lung machines. Endovascular techniques are successfully used to treat ventricular septal defects, atrial septal defects, patent ductus arteriosus, and aortic stenosis.
What is a heart-lung machine?
A heart-lung machine has been used in medicine since 1953, when, using the world's first apparatus, J. Gibbon performed an operation to suture the atrial septum. The operation was performed on a beating heart, but the blood did not pass through the lungs, and it was saturated with oxygen using a heart-lung machine. The first devices were unsafe, it was difficult to operate them, and about 5 liters of donor blood were spent during the operation.
The devices were, however, improved. Techniques of hypothermia (lowering body temperature), hemodilution (blood dilution), and myocardial protection appeared. Today, the use of heart-lung machines has a minimal adverse impact on the body.
A heart-lung machine consists of the following two units:
- a mechanical unit that temporarily replaces a person's heart;
- a physiological unit that replaces the lungs.
The mechanical unit includes a pump, which can be roller or centrifugal, and artificial circulation safety control systems that record pressure, temperature, air bubbles, tank level, etc. The main thing in the mechanical unit is a pump that replaces the heart. Depending on whether doctors use full or assisted artificial blood circulation, it can operate in a variety of modes, replacing total or partial minute blood exchange.
The physiological unit includes an oxygenator. It saturates the blood with oxygen and absorbs carbon dioxide from it, which means that it does what the human lungs usually do. German hospitals perform surgical treatment using a heart-lung machine with membrane oxygenators. Gas exchange is carried out through a gas-permeable membrane in this device. The advantages of using such heart-lung machines are the absence of mechanical damage to proteins and blood cells, as well as the provision of an optimal blood gas composition, due to which organs and tissues always receive a sufficient amount of oxygen.
How is a heart-lung machine connected for congenital and acquired heart defects?
Depending on the disease being treated, a heart-lung machine can be connected in different ways. In any case, the device takes blood from some blood vessels and returns it to others.
In standard cases, the device is connected to the superior or inferior vena cava and the aorta. This option is suitable for operations in which the heart chambers are opened.
Sometimes the heart is not opened, for example, during the treatment of congenital heart defects that affect only large blood vessels. One venous catheter is sufficient in this case. Two-section models are also used, which take blood from the right atrium and return it to the inferior vena cava.
In cases where operations are performed on the aorta and revision surgical interventions are performed on the heart, the catheter is often placed in the femoral artery. Occasionally, the left atrium and left ventricle are used, as well as the femoral artery and femoral vein connection. These options are mainly used during operations on the thoracoabdominal aorta.
The diameter of the catheter is selected individually. It depends on the patient's body weight, the diameter of their blood vessels, and the mode of the heart-lung machine. In standard cases, the diameter of the catheter is no more than two-thirds the diameter of the blood vessel. It is important to place the catheters properly and constantly monitor the pressure to avoid complications such as blood vessel dissection or tissue edema due to impaired venous return.
Where to have your treatment for congenital and acquired heart defects?
You can undergo your treatment in Germany. Doctors in this country achieve outstanding results in the treatment of congenital and acquired heart defects. Surgeons completely cure the disease, normalizing hemodynamics and preventing the development of arrhythmias, heart failure, and other complications. There are a few reasons for you to undergo your treatment in Germany. These are the following:
- state-of-the-art heart-lung machines are used, which almost never injure blood cells and proteins and also maintain the optimal blood gas composition;
- modern myocardial protection techniques are used, which allows for the avoidance of complications;
- the best Cardiosurgery Centers perform robot-assisted heart surgery;
- several heart defects can be repaired at the same time;
- if necessary, surgical treatment of several diseases is carried out simultaneously in one operation, for example, a heart defect and coronary heart disease;
- following surgery, patients receive comprehensive care, adequate pain relief, symptomatic therapy, and cardiac rehabilitation.
You can find out the prices for treatment on the Booking Health website. The website offers the current cost of treatment in Germany. You can compare the cost of treatment in Germany at different hospitals to choose a medical care program at the best price. The Booking Health specialists will help you make the right choice and provide services for the organization of treatment. When you make your treatment appointment through the Booking Health service, the cost of treatment in Germany will be lower for you due to the absence of taxes for foreign patients.
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
