Surgical Correction of Total Anomalous Pulmonary Venous Connection 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.
A total anomalous pulmonary venous connection is a critical heart disease. The condition requires treatment in the first months of a child's life. You can undergo your treatment in Germany and count on a complete cure for the disease without any health consequences. You can find the cost of treatment in Germany and choose a medical care program at the best price on the Booking Health website.
Content
- What is a total anomalous connection?
- Treatment principles for a total anomalous pulmonary venous connection
- Methods of correcting total anomalous pulmonary venous connections
- Surgical outcomes for a total anomalous pulmonary venous connection
- Where to have treatment for your total anomalous pulmonary venous connection?
What is a total anomalous connection?
A total anomalous pulmonary venous connection means that the pulmonary veins do not open where they should. Normally, they carry blood from the lungs to the left atrium, that is, to the arterial part of the heart. If a pathological connection occurs, they will open into the cavity of the heart or blood vessels that contain venous blood.
As a result, a situation arises in which oxygen-rich blood cannot enter the systemic circulation and instead returns back to the lungs.
In children, immediately after birth, the ductus arteriosus remains open, and there is also communication between the atria. As long as they remain open, a small amount of arterial blood can enter the systemic circulation. However, when these communications are closed, the patient's condition becomes critical.
Treatment principles for a total anomalous pulmonary venous connection
A total anomalous pulmonary venous connection requires surgical treatment in a short time. If left untreated, mortality during the first year of life reaches 80%.
The following operations to treat the disease can be performed:
- radical surgery is the treatment aimed at repairing the defect and restoring normal hemodynamics;
- palliative surgery is the treatment that helps to temporarily stabilize the patient's condition so that it can be followed by a radical correction of the defect.
The preservation of hemodynamics in patients with a total anomalous pulmonary venous connection depends on whether any communication between the atria is maintained. This is the main route by which arterial blood enters the systemic circulation to oxygenate organs and tissues. Palliative treatment therefore increases the opening between the atria. This is done through a procedure called a balloon atrial septostomy. This is a type of minimally invasive treatment. Doctors deliver the balloon to the area between the atria through an incision in the groin and inflate it with saline. The balloon expands and enlarges the atrial defect.
Radical correction is performed during an open intervention. The purpose of this operation is to reconnect the pulmonary veins so that they deliver blood from the lungs to the left side of the heart.
Methods of correcting total anomalous pulmonary venous connections
Doctors use different types of interventions to repair total anomalous pulmonary venous connections as the types of malformation vary. In different patients, the pulmonary veins connect to different systemic veins and heart chambers. In addition, concomitant anomalies in the structure of the heart and large vessels are often encountered, and these problems also need to be solved during the surgical intervention.
In the first and third types of the defect, an anastomosis is applied between the left atrium and the pulmonary vein collector during the operation. The area of the anastomosis should not exceed the area of the atrioventricular orifice. Many patients have atrial septal defects, or they are caused by doctors. The defect is eliminated with a patch during the surgical procedure.
For type 2 defects, the correction is easier. The pulmonary vein ostia is usually wide. It is simply transferred from the right atrium to the left, with a simultaneous plastic repair of a septal defect between the atria. In the case of veins connecting to the coronary sinus, the VanPraaghc modification is applied.
Surgical repair of the infracardiac form of the defect is considered technically complex when the pulmonary veins open into the vena cava or other blood vessels below the diaphragm. They are far from the heart. As a result, they cannot simply be reconnected, so the doctors have to perform a reconstructive stage.
Although most interventions for a total anomalous pulmonary venous connection are performed through an open sternotomy approach, minimally invasive endoscopic operations using the da Vinci surgical system have begun to be performed at leading German hospitals in recent years. They are made through several incisions between the ribs. Such operations are safer, blood loss is reduced, and a patient recovers faster after surgical treatment.
Surgical outcomes for a total anomalous pulmonary venous connection
In the 20th century, the mortality rate for operations to repair total anomalous pulmonary venous connections reached 25%, but today it has decreased to an average of 6%. The mortality rate of patients is several times lower at leading hospitals in Germany. The best results can be achieved through a radical correction at the age of up to 3 years.
Lethal outcomes are usually caused by initially severe conditions in patients, such as pulmonary hypertension and low blood oxygen saturation. Hypoplasia (small size) of the left heart and an infracardiac anomalous pulmonary venous connection are also considered poor prognostic factors.
In Germany, the vast majority of operations are successful. Patients fully recover after surgery. Hemodynamic parameters normalize within a few months. Within a year, most of those who have been operated on do not have any symptoms.
The complications following the surgical treatment of anomalous pulmonary venous drainage at hospitals in Germany are rare. Pulmonary vein stenosis (narrowing) is the main one. It can, however, be eliminated with a minimally invasive procedure called balloon angioplasty. In Germany, this procedure is performed through an incision in the groin. Complications may develop in only a few patients. Most of those operated on will not need any surgery or minimally invasive procedures for congenital heart disease, even in the distant future.
Where to have treatment for your total anomalous pulmonary venous connection?
You can get help by seeking medical attention at one of the Cardiac Surgery Hospitals in Germany to undergo a surgical repair of the heart defect. You are welcome to use the Booking Health service to find out the cost of treatment in Germany, compare prices, and choose a medical care program at a favorable price.
There are a few reasons for you to undergo your treatment in Germany. These are the following:
- advanced medicine;
- highly qualified cardiac surgeons with high authority not only in Germany, but also far beyond its borders;
- modern, well-equipped Departments of Cardiac Surgery;
- successful operations on patients of any age, including newborns;
- palliative interventions are performed using minimally invasive endovascular techniques;
- the best Cardiac Surgery Centers offer robot-assisted operations;
- a low mortality rate and a low risk of complications;
- reliable results that last for life.
When you select a medical care program through Booking Health, the cost of treatment in Germany will be lower. Prices for treatment in Germany will be reduced due to the absence of taxes for foreign patients. The initial cost of treatment in Germany will not increase because you will be insured against unforeseen medical expenses.
The Booking Health specialists will provide you with services for organizing your trip abroad. We will help you select a hospital in Germany, contact its administration, and schedule an appointment on your preferred dates. We will also book a hotel room and airline tickets, meet you at the airport, and take you to the hospital by car. You will benefit from support and assistance in solving any organizational issues during the entire period of your treatment in Germany. After the completion of your treatment in Germany, we will take care of your transfer from the hospital to the airport. We will provide you with the opportunity to receive medical consultations within 3 months upon the completion of your medical care program. We will also buy medicines in Germany and forward them to your native country, if necessary.
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
