Reconstruction Surgery for Patent Foramen Ovale (PFO) 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 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 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 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 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 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 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 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 patent foramen ovale (PFO) is a common heart anomaly that is not considered a defect. It occurs in about 25% of the population and usually does not affect health due to its small size. A large foramen ovale, however, is dangerous. Thrombi may penetrate from the venous half of the heart into the arterial half. From there, they can enter the cerebral vessels and cause a stroke. The large patent foramen ovale, therefore, requires treatment even if a patient has no symptoms. If you have this heart anomaly, you can get help at one of the German hospitals. You are welcome to use the Booking Health website to find out the cost of treatment in Germany and choose a medical care program at the best price.
Content
- What is a foramen ovale?
- Indications for the treatment of a patent foramen ovale
- Who may need surgery for a patent foramen ovale?
- How is surgery for a patent foramen ovale performed?
- Where to get treatment services for your patent foramen ovale?
What is a foramen ovale?
A foramen ovale is an opening between the two atria that functions during fetal development. After the birth of a child, it becomes unnecessary and closes within a few months.
This happens to 75% of people. However, in about 25% of children, the foramen ovale remains open. This does not affect health in any way and does not cause any symptoms, so the fact that the foramen ovale has not closed can rarely be detected immediately. It is usually an incidental finding in adults during diagnostics for other diseases.
The size of the patent foramen ovale usually ranges from 1 to 19 mm. It increases over time. The average size is 4.5 mm.
The patent foramen ovale is usually diagnosed after a stroke. Contrast-enhanced echocardiography is used to detect it. This examination allows doctors to assess in which direction and how intensively blood is discharged through the foramen ovale from the right half of the heart to the left. A contrast agent is administered intravenously. Transthoracic (through the chest wall) echocardiography is then performed. Doctors do a clear test and an ultrasound scan with the Valsalva maneuver (before the contrast is injected, a patient takes a deep breath, straining and exhaling).
Indications for the treatment of a patent foramen ovale
In most patients, a patent foramen ovale does not affect health. A little amount of blood is discharged from the venous part of the heart into the arterial part, but hemodynamics is not impaired.
The main problem with the patent foramen ovale is the high risk of stroke. If a stroke occurs at a young age, in half of the cases, doctors detect the patent foramen ovale in the patient during diagnostics.
In addition, this cardiac anomaly causes migraine attacks. It affects 50% of patients, and often the headache is accompanied by neurological symptoms. There are two causes of migraine:
- Serotonin and other substances pass from the right atrium to the left, avoiding metabolic transformation in the lungs. They enter the systemic circulation faster and in higher concentrations, and when they reach the brain, they can stimulate receptors in susceptible people.
- Microemboli can pass through the patent foramen ovale, causing oxygen deprivation in tissues and irritating the cerebral cortex, leading to migraine and depression.
Despite the fact that the patent foramen ovale has a negative impact on health in some people, the mere detection of it does not warrant the necessity for treatment. Even after a stroke, treatment is not always required. Treatment may be conducted in the following cases:
- a stroke before the age of 60;
- a stroke after the age of 60, if it is definitely established that the cause of the stroke was the patent foramen ovale;
- a previous stroke in combination with atrial fibrillation or venous thromboembolism;
- systemic thromboembolism (without stroke);
- platypnea syndrome is when a patient has shortness of breath in a standing position and, at the same time, other causes of it are excluded, with the exception of the patent foramen ovale.
Who may need surgery for a patent foramen ovale?
Surgical reconstruction for a patent foramen ovale is rarely performed.
In most patients, the patent foramen ovale is not treated at all. If there is an indication for its closure, doctors use minimally invasive techniques, such as the Cardioseal Septal system or the amp Later PFO occluder, to close the foramen ovale through an endovascular approach. Manipulations are carried out from the inside of the blood vessels. A small incision in the groin area is sufficient to deliver the device to the heart and place it in the area of an atrial septal defect.
Surgical closure of the patent foramen ovale is required only when two conditions are combined:
- indications for the treatment of the patent foramen ovale;
- the impossibility of endovascular treatment.
The reasons why the patent foramen ovale cannot be closed using an endovascular technique may be different. For example, the procedure is not technically available because it is not available at the hospital due to a lack of equipment or specialists. Perhaps an endovascular intervention is technically impossible to perform because:
- the diameter of the patent foramen ovale is too large, exceeding 2.5 cm;
- there is too little normal tissue left in the septum of the heart on one of the edges, so it is impossible to securely fix the occluder;
- the septum of the heart is deformed.
In addition, after an endovascular procedure, long-term use of anticoagulants is required, at least for six months. For some patients, they are contraindicated due to the risk of severe bleeding. In such a case, doctors may opt for surgery, since after surgical reconstruction, anticoagulants are used for only a few days.
In some patients, the patent foramen ovale is accompanied by other heart defects. If they require open-heart surgery, the foramen ovale can be closed simultaneously.
How is surgery for a patent foramen ovale performed?
Surgery is performed using open surgical techniques under general anesthesia. The heart is approached through a chest incision. A patient is connected to a heart-lung machine. The device performs the functions of the heart and lungs, while doctors perform the necessary manipulations on the patient's temporarily stopped heart.
When performing the operation, doctors dissect the chest and right atrium, after which a patch is placed on the defect site. The patch may consist of the patient's own pericardium or artificial materials. If necessary, comorbidities can be eliminated as well.
After surgery, the patient's symptoms disappear, for example, migraine attacks or shortness of breath, which are typical of a large foramen ovale. The risk of stroke is reduced to the average in the population. The prevention of stroke is one of the main goals of the treatment of the disease.
Where to get treatment services for your patent foramen ovale?
If you need services to close your foramen ovale, you can undergo treatment in Germany. Healthcare facilities in this country offer top-class medical services. Treatment at German hospitals has the following benefits:
- doctors have state-of-the-art equipment;
- a high level of medical training for cardiac surgeons;
- reliable results of the surgical intervention and freedom from revision surgery;
- treatment that is safe for your health: the frequency of complications at German hospitals is several times lower than the world average;
- high-quality postoperative care, symptomatic therapy, comprehensive rehabilitation, and comfortable conditions at German hospitals.
You are welcome to use the Booking Health website, where you can find out the cost of treatment in Germany and compare prices at different German hospitals. You can also make an appointment for your treatment in Germany through Booking Health. When receiving medical services through Booking Health, the cost of treatment in Germany will be lower for you than when you contact a German hospital directly. The price for services is reduced due to the absence of high taxes for foreign patients. The initial cost of treatment in Germany will not increase for you, even if additional medical services are required, because you will receive insurance that will cover unforeseen medical expenses.
The medical tourism agency Booking Health will provide you with services for organizing your treatment in Germany, while you can fully concentrate on the restoration of your health. We will contact the hospital and schedule an appointment for your preferred dates. We will also book the nearest hotel to the hospital, buy airline tickets, and translate your medical records into German. Our company's specialists will meet you at the German airport and take you to the hospital by car. After the completion of your treatment in Germany, we will take care of your return transfer.
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
