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Pulmonary Valve Replacement abroad

University Hospital Essen

9.6/10
location_onGermany, Essen

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.

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Hospital directly39644.35
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University Hospital Oldenburg

10/10
location_onGermany, Oldenburg

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 diseases of the cardiovascular system! The department offers the full range of services in this ​​medical field. Many heart surgeries are performed using minimally invasive technique, which has a positive effect on the healing of an operative wound. The patient also experiences less pain and the hospitalization period is significantly reduced. Thanks to long experience of doctors and modern equipment, the department provides excellent results in the treatment of heart pathologies.

Hospital directly33942.5
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University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Cardiothoracic Surgery

The Department of Cardiothoracic Surgery offers the full range of surgical treatment of diseases of the heart, lungs, thoracic organs and blood vessels. Medical care is provided 24 hours a day. The doctors of the department prefer an individual approach to each patient and take into account all his needs and wishes. In clinical practice, doctors apply both classic and innovative surgical techniques in order to achieve the best therapeutic results.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

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.

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

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.

University Hospital RWTH Aachen

9.5/10
location_onGermany, Aachen

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.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

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.

University Hospital Bonn

9.2/10
location_onGermany, Bonn

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.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

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.

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

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.

University Hospital Jena

8.9/10
location_onGermany, Jena

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.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Cardiothoracic Surgery

The Department of Cardiothoracic Surgery covers the entire range of top-class medical services in this field. Special attention is paid to minimally invasive operations, which, along with the optimal functional result, ensure minimal traumatization, fast recovery and the absence of a cosmetic defect. The optimal type of therapy is selected in collaboration with the specialists from all the necessary related disciplines and adapts to the specific clinical indications of the patient.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

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.

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

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.

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

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.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

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.

Pulmonary valve regurgitation is a rare heart disease, usually acquired, and it develops mainly at a young age. This condition can be a consequence of heart surgery to treat tetralogy of Fallot and also develops due to pulmonary hypertension, rheumatic diseases, infective endocarditis, and heart tumors. The main treatment method for this disease is heart valve replacement surgery. Surgeons abroad perform it not only with the help of open heart surgical techniques, but in some cases, it can be performed using an endovascular technique through the blood vessels. You are welcome to use the Booking Health service to find the cost of treatment abroad and make your appointment at a specialized hospital.

Content

  1. What is pulmonary valve regurgitation?
  2. Treatment principles
  3. Heart valve replacement
  4. Minimally invasive artificial heart valve implantation
  5. Where to undergo treatment?

What is pulmonary valve regurgitation?

 

The pulmonary valve is located in the pulmonary artery. It receives venous blood from the right ventricle, and then it goes to the lungs to give off carbon dioxide and be saturated with oxygen.

Normally, the valve should allow blood to pass only in one direction, namely towards the lungs. The release of blood occurs during cardiac muscle contraction. Then comes the period of relaxation of the heart. In this phase, the heart valve closes and does not allow blood to flow in the opposite direction, preventing it from returning back to the right ventricle.

Pulmonary valve regurgitation is a condition in which the heart valve cannot close the pulmonary artery completely. As a result, during the period of relaxation of the heart , part of the blood returns back to the right ventricle, overloading it with volume.

Pulmonary valve regurgitation was graded as: 

  • grade 1 occurs when up to 25% of the blood returns back; 
  • grade 2 occurs when up to 50% of the blood returns back; 
  • grade 3 occurs when more than 50% of the blood returns back;

Pulmonary valve regurgitation can be absolute or relative. An absolute form of heart disease means that the valve itself is damaged. Relative regurgitation is more common. In this case, the heart valve does not have any pathological changes, but the lumen of the pulmonary artery increases, so it does not close completely. The most common cause of relative pulmonary valve regurgitation is pulmonary hypertension (elevated pressure in the pulmonary artery due to increased pulmonary vascular resistance).

Treatment principles

 

In the case of pulmonary valve regurgitation, doctors usually do not repair the valve. The main treatment method is heart valve replacement. In most patients, it is performed using open surgery, that is, through an incision in the chest. Some patients may have a minimally invasive implantation of an artificial heart valve through the blood vessels.

Pulmonary valve regurgitation does not always require medical attention. It is not as severe as other valvular regurgitation, but over time it can lead to changes in the heart. When a disease is detected, patients are monitored. Operations can be performed in the following cases:

  • pulmonary valve regurgitation of grade 2-3;
  • the onset of symptoms, such as shortness of breath;
  • even if clinical manifestations only appear during exercise tests, a patient may be offered surgery.
  • right-sided ventricular heart failure; 
  • dilatation of the right ventricle. 

Heart valve replacement

 

Pulmonary valve replacement involves the implantation of an artificial valve. They are mechanical and biological. Mechanical valves are not placed in the position of the pulmonary artery because blood flow is relatively slow here, and blood clots often occur even if a patient is constantly taking anticoagulants.

During the operation, only biological valves are implanted. They have a shorter service life since, unlike mechanical ones, they gradually degrade (wear out). This is the main problem in the treatment of pulmonary valve regurgitation because most patients are young people, as well as children who have undergone surgical repair of tetralogy of Fallot.

In developed countries, the problem of repeated operations is partially solved. Repeated heart valve replacement can be performed using minimally invasive techniques, namely without opening the chest but through an incision in the leg.

The worst survival of biological prostheses is noted in children:

  • the 5-year survival rate reaches 80%;
  • the 10-year survival rate is 60%.

The problem is not only the degradation of the valve but also the dilation of the diameter of the pulmonary artery as the child grows. As a result, the prosthesis is untenable, and doctors have to implant a new one.

In adults, heart valve prosthesis survival rates are better. They usually serve 15 to 30 years. But in any case, a second operation will be required sooner or later. Perhaps it will not be the only one in the patient's life.

Healthcare professionals at some specialized centers already perform operations to implant the latest types of heart valves that are made of biodegradable materials. They are gradually destroyed and replaced by the patient's own tissues after their implantation. As a result, a child receives a native heart valve that grows with them and will not require any heart valve replacement surgery in the future. But these are new types of artificial heart valves that have been developed recently and are currently only used in clinical trials. It remains to be seen what long-term results will be obtained after their implantation, as research continues.

Minimally invasive artificial heart valve implantation

 

In some cases, an artificial pulmonary valve can be implanted using minimally invasive techniques through an incision in the leg.

Such operations are often performed for repeated pulmonary valve replacement surgery. A new artificial valve is placed inside a biological prosthesis that has lost its function due to degenerative processes. An endovascular intervention is performed from the inside of the blood vessels under X-ray guidance. It is not necessary to recover for a long time after such operations, and the risk of complications is much lower.

Minimally invasive implantation of an artificial pulmonary valve is less commonly done in patients with newly diagnosed regurgitation. Approximately 20% of children after the repair of tetralogy of Fallot are considered candidates for such an operation. A condition for minimally invasive heart valve replacement is the small size of the valve ring. In addition, new types of prostheses have been developed that can be placed even in a large diameter valve ring, but so far they are used only in clinical trials.

Here are some benefits of implanting an artificial heart valve through the blood vessels compared to open heart surgery:

  • minimal trauma rate; 
  • no connection to a heart-lung machine is required; 
  • minimal blood loss;
  • quick recovery after surgery;
  • low risk of complications; 
  • smooth course of the postoperative period; 
  • short hospital stay. 

Where to undergo treatment?

 

If you are diagnosed with problems with your heart valves, you can seek medical attention from one of Heart Surgery Centers abroad. Tremendous progress has been made in the treatment of heart disease in developed countries. Heart defects can be successfully repaired at any age.

There are a few reasons for you to undergo your treatment abroad. These are as follows: 

  • safe and efficient operations at the Centers of Excellence; 
  • you will be operated on by the best surgeons in the world;
  • the latest types of artificial heart valves with a long service life are implanted, providing the best hemodynamic parameters;
  • several heart defects can be repaired simultaneously during a single surgery;
  • minimally invasive techniques from within the blood vessels can sometimes be used to replace a pulmonary valve;
  • patients receive adequate symptomatic therapy and quality care after surgery, and then they can undergo cardiac rehabilitation.

On the Booking Health website, you can find the cost of treatment abroad and choose the most suitable medical care program. Our specialists will help you to find a hospital that specializes in the treatment of valvular diseases, uses innovation, and achieves the best results. When making your treatment appointment at a hospital through the Booking Health website, the cost of treatment will be lower due to the absence of additional fees for foreign patients. You will also get insurance that will cover all medical expenses not provided for by the original medical care program. The Booking Health staff will fully organize your trip, and you can focus on restoring your health.

 

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:

National Library of Medicine

NORD - National Organization for Rare Disorders

Mayo Clinic




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