Mitral Valve Insufficiency (prolapse) with Repair of Mitral Valve (minimally Invasive) 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.
Mitral valve regurgitation is a common heart disease, affecting up to 2% of the population. The main method of treatment is surgical repair. But if a patient has concomitant heart disease and pathologies of other organs, the surgical risk is too high. In this case, the operation is contraindicated, and heart valve repair can be performed using minimally invasive techniques. German hospitals perform effective procedures for minimally invasive treatment of cardiac diseases through an incision in the groin, while procedures through a short chest incision are uncommon. You can get information about the methods used and the cost of treatment in Germany on the Booking Health website.
Content
- Techniques for minimally invasive valve repair
- Where to have your minimally invasive treatment for the disease?
Techniques for minimally invasive valve repair
Many techniques have been developed to repair the valve in the event of its insufficiency. Since secondary mitral valve insufficiency is the most common, most systems aim to reduce the diameter of the fibrous ring. They are designed for a direct or indirect annuloplasty. A direct annuloplasty reduces the annulus itself, while an indirect annuloplasty reduces the coronary sinus. This creates tension that is transmitted to the fibrous ring, and, as a result, it also decreases. The main advantage of indirect annuloplasty is the technical simplicity of mitral valve repair. The minimally invasive procedure is successfully performed even by doctors with little experience, and the risk of a technical failure is very low.
The Monarc system was the first device for a minimally invasive indirect annuloplasty. It, however, failed clinical trials because 25% of patients had coronary artery occlusion.
The Viacor PTMA system has also not entered clinical practice. This is a polytetrafluoroethylene catheter that was minimally invasively implanted into the patient's coronary sinus to reduce the anteroposterior size of the mitral annulus. But it turned out that the device severely damaged the patient's coronary sinus, so it was discontinued.
The Carillon system is currently the only approved system for minimally invasive valve repair using an indirect annuloplasty. It has been used in Germany since 2011. The system has two anchors connected to each other. They are inserted using a minimally invasive technique through the patient's jugular vein. The advantage of the device is the ability to reposition or remove the system if significant mitral valve regurgitation remains after valve repair.
Recent modifications to the Carillon system have performed well in clinical trials, although it has limitations. With a severe expansion of the cavities of the patient's heart, the location of the coronary sinus relative to the mitral valve may change. If the coronary sinus is localized along the left atrium, fibrous ring compression may not be sufficient for full valve repair. However, in 85% of patients, the technical success of the minimally invasive procedure is achieved.
Another problem with early Carillon mitral valve repair devices was the frequent failure of one of the anchors. This design flaw, however, has been eliminated. Today, such breakdowns after valve repair are practically nonexistent.
The Mitralign system is a device approved in Germany for a direct annuloplasty. During a minimally invasive mitral valve repair, it is placed directly into the annulus fibrosus. With the Mitralign system, mitral valve surgery becomes more complicated. It, however, provides good results in heart valve repair. The technical complexity of the minimally invasive procedure is not a problem for patients who are treated at a good Cardiac Surgery Center. Based on the results of the minimally invasive treatment of the disease with the implantation of the Mitralign system, the diameter of the patient's valve decreases by an average of 2 cm. This is an excellent result, which provides a decrease in the severity of mitral regurgitation or complete repair of normal heart valve function.
The Valtech CardioBand system is another approved technique for mitral valve repair using minimally invasive techniques. The minimally invasive device implantation procedure is performed through a transseptal atrial approach (through the septum of the patient's heart). This is a Dacron band, which is put on the fibrous ring by screwing in the clamps. This tape is then stretched under echocardiographic guidance until it reaches the normal diameter of the heart valve opening.
The iCoapsys system consists of two epicardial pads connected by a suture. This not only reduces the size of the fibrous ring but also normalizes the shape of the left ventricle. The RESTOR-MV study showed that the minimally invasive technique is not only as good as a surgical annuloplasty but even outperforms it in terms of left ventricular size reduction, reduction in mitral valve regurgitation severity, and patient survival rates.
The ARTO system is aimed at changing the anterior-posterior size of the left atrium. The device is delivered to the patient's heart using minimally invasive techniques through the femoral vessels and then through the jugular vein and coronary sinus. A special magnetic catheter, MagneCath, is used to implant this system.
The BACE system is used to repair left ventricular function using minimally invasive techniques. This is a circular bandage with inflatable chambers. The device is placed around the basal part of the patient's beating heart. When the heart chambers are filled with saline, the subvalvular structures are displaced, resulting in a repair of the shape of the ventricle and a decrease in the severity of mitral valve regurgitation.
The NeoChord device is used for mitral valve prolapse. Valve prolapse is one of the mechanisms for the development of mitral valve regurgitation, which is associated with the deflection of the valves in the opposite direction, that is, into the atrium. Posterior mitral valve prolapse may be associated with a detachment of the chord, which is the thread that holds it. In this case, a minimally invasive chord prosthetic repair is possible to correct the prolapse.
Although this technique for treating valve prolapse is also minimally invasive, it requires a small chest incision. With the NeoChord system, a new chord is formed. If prolapse treatment results are unsatisfactory, it can be removed or additional threads may be implanted. Prolapse repair involves the threads being stretched and fixed to the left ventricular apex. Good results in the treatment of prolapse with the system were confirmed in the TACT study, where the technical success of the procedure was achieved in 87% of patients. Most patients require the implantation of 3 or 4 artificial chords to achieve the final results.
The MitraClip system is a coaptation device. This is a "clothespin" that is applied to the heart valve leaflets, bringing them together. As a result, their coaptation is repaired, and the heart valve leaflets better close the opening between the heart chambers. It is the oldest system for minimally invasive treatment of mitral valve diseases and has been in use since 2002. Tens of thousands of patients worldwide have already undergone the minimally invasive MitraClip heart disease treatment.
Where to have your minimally invasive treatment for the disease?
The surgical treatment of the disease is too traumatic. For many patients, surgery is contraindicated due to concomitant conditions of the heart and other organs. In such cases, an alternative to open surgery is a minimally invasive procedure. It can provide the same results. Unlike the surgical technique, this treatment of the disease is safer and does not require a long recovery.
Minimally invasive procedures for the treatment of heart disease are used in most major German hospitals. Treatment in Germany provides excellent results. The specialists at German hospitals use modern devices for minimally invasive treatment of cardiac diseases.
You can get information about diseases, doctors, prices, and leading surgical departments on the Booking Health website. Our website presents the current cost of treatment in Germany. When you make your appointment for minimally invasive or surgical treatment of cardiac diseases through Booking Health, the cost of treatment in Germany will be lower for you than if you contact German hospitals directly. The prices are reduced due to the absence of taxes for foreign patients.
Please leave your request on the Booking Health website to get additional information, assistance in selecting a German hospital, or a service for organizing your minimally invasive or surgical treatment in Germany. The Booking Health specialists will contact the administration of the German hospital, schedule the patient's appointment for the preferred dates, book airline tickets and the nearest hotel to the German hospital, and translate medical documents. The company's employees will meet the patient at the airport, provide interpreting services, and take the patient to the German hospital by car. After the completion of the patient's minimally invasive treatment in Germany, the company's specialists 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:
ECR - European Cardiology Review
