Endovascular Tricuspid Valve Repair for Tricuspid Valve Insufficiency 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 is one of the best medical facilities in Germany specializing in the surgical treatment of cardiovascular disease! The department offers the full range of modern surgical interventions on the heart with a special emphasis on heart valve repair and replacement, aortic surgery, coronary artery bypass grafting, pacemaker and defibrillator placement, and artificial heart system implantation. The healthcare facility performs more than 3,500 surgical procedures annually, most of which are complex, earning the department the status of one of the largest heart surgery centers in Germany with world-class medical services. In addition, the department has exceptional experience in performing heart-lung transplants and occupies a leading position among clinics specializing in this area in the international healthcare system. The department is proud of its high-tech equipment, which contributes to the high efficiency and safety of surgical treatment of cardiac pathologies. In their daily clinical practice, the department's surgeons make extensive use of the achievements of modern cardiac surgery, especially minimally invasive and catheter-based techniques. The professional skills of the department's cardiac surgeons deserve special attention – some of the best specialists in Europe, trained in top hospitals in Germany, other European countries and the USA, take care of the heart health of the patients in the department.
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.
Tricuspid valve regurgitation is a common heart disease in older patients. It is usually secondary, caused by the fibrous ring enlargement. This condition develops due to mitral defects, coronary heart disease, and heart failure. A problem that impairs hemodynamics is an increased diameter and area of the tricuspid valve. The area of the heart valve can be reduced with the help of surgery. If you opt to undergo your treatment in Germany, there is another option for solving the problem: a minimally invasive procedure that is performed from the inside of the blood vessels. The procedure is non-traumatic and does not require any long-term rehabilitation. You can use the Booking Health service to find out the cost of treatment in Germany, compare prices at different hospitals, and choose a treatment program that is best for you.
Content
- Who may be a candidate for endovascular treatment of tricuspid valve insufficiency?
- How is tricuspid valve repair performed?
- Treatment outcomes for tricuspid valve insufficiency
- Why to undergo your tricuspid valve insufficiency treatment in Germany?
Who may be a candidate for endovascular treatment of tricuspid valve insufficiency?
Endovascular repair of tricuspid valve insufficiency is not considered the first choice. It is used only if there are contraindications to open surgical repair or heart valve replacement.
Operations on the tricuspid valve are complex, unsafe, and have a high mortality rate, which reaches 30% in countries with a low level of medicine and about 10% in Germany. At the same time, the risk of complications reaches 40% even in developed countries.
Surgical interventions on the tricuspid valve are significantly more dangerous for a patient and have worse outcomes as compared to operations on the mitral or aortic heart valve. Open surgical interventions are therefore avoided by doctors whenever possible, especially in elderly and debilitated patients who often have cardiac arrhythmias and heart failure.
For many patients, an endovascular intervention is a good alternative to traumatic open surgery. The procedure allows doctors to achieve good, long-term results with minimal health risks and without the need for a long postoperative recovery.
Up to 90% of cases of tricuspid regurgitation are a secondary form of heart disease. This means that the heart valve itself is not damaged, but the opening that it closes is enlarged due to dilatation of the right ventricle and atrium. Therefore, the main goal of endovascular tricuspid valve repair is to reduce its area to lower the severity of tricuspid regurgitation and improve heart function.
How is tricuspid valve repair performed?
The procedure is performed without any chest incisions. Doctors make an incision in the groin to enter the right chambers of the heart through the blood vessels. The approaches and techniques for performing the procedure vary for different types of devices. However, in any case, the treatment of tricuspid valve disease is minimally traumatic without general anesthesia and without a significant risk of complications typical of open surgery. Patients do not require long-term rehabilitation after the intervention.
The first tricuspid valve repair using an endovascular technique was performed in Germany. Doctors used the Mitralign system to reduce the size of the tricuspid valve annulus. This procedure was successfully carried out in 2015. The system was not used for its intended purpose. As its name suggests, it was originally developed for mitral valve repair. The Mitralign implantation procedure is performed through an incision in the groin. The system is implanted through the jugular vein.
Later, doctors began to perform valve repairs using other systems. For example, physicians have successfully implanted the Israeli-made Cardioband system. This is a Dacron band, which is put on the fibrous ring of the tricuspid valve by gradually screwing in the fixing elements. If necessary, these can be removed from the fibrous ring to implant them differently. The procedure is performed under transesophageal echocardiography guidance. Healthcare professionals in Germany use a 3D version of the procedure. The band is tightened under echocardiography guidance until the target values of the tricuspid valve orifice area are achieved.
The Cardioband system has been used relatively recently. Only in 2015 were the results of the first prospective trial of its use in a group of patients with mitral insufficiency presented. Since 2021, there have been publications that describe the use of Cardioband for the repair of secondary tricuspid valve insufficiency.
Treatment outcomes for tricuspid valve insufficiency
In 2022, the results of the examination of patients one year after the treatment of severe tricuspid insufficiency using the Cardioband system were published. The trial included 37 patients with an average age of 78 years. About 97% of them had atrial fibrillation.
After 1 year, about 73% of treated patients had grade 2 or lower tricuspid valve regurgitation. The reduction in the size of the annulus fibrosus persisted. Only 5% of cases required revision intervention. In 92.3% of patients, the functional class of heart failure decreased to 1 or 2. The authors concluded that transcatheter valve repair is:
- safe;
- provides good results that persist a year after treatment;
- provides a low rate of repeated hospitalizations;
- improves the quality of life.
Good results are also achieved with other systems. These help reduce the severity of tricuspid valve disease in conditions where other treatment methods are not possible due to contraindications. Patients feel better almost immediately after the procedure. They experience less need for drug therapy and better tolerate physical activity.
Benefits of endovascular tricuspid valve repair include the following:
- minimal trauma rates;
- no need for general anesthesia;
- does not require a long recovery;
- a short hospital stay;
- a low risk of cardiac complications and a low mortality rate as compared to open heart surgery.
Why to undergo your tricuspid valve insufficiency treatment in Germany?
Doctors at German hospitals achieve excellent results in the treatment of tricuspid valve defects and other heart diseases. It was here that the world's first endovascular tricuspid valve repair procedure was performed using the Mitralign system. Although minimally invasive procedures on the tricuspid valve are not yet available in many countries, endovascular treatment for tricuspid regurgitation has been performed in Germany for several years.
There are a few reasons for you to undergo your treatment in Germany. These are the following:
- German hospitals have state-of-the-art equipment;
- doctors with extensive experience in the minimally invasive treatment of tricuspid valve diseases work in German medical facilities;
- doctors use the latest systems for a tricuspid percutaneous annuloplasty;
- minimally invasive treatment of several heart defects can be performed simultaneously, for example, additional elimination of mitral regurgitation;
- a low risk of complications from endovascular procedures;
- high-quality care and comfortable conditions at German hospitals;
- a relatively low cost of treatment in Germany as compared to other developed countries.
You are welcome to use the Booking Health service to undergo your tricuspid valve repair at a German hospital, find out the cost of treatment in Germany, and choose a medical care program at the best price. Even the most severe heart diseases are successfully treated here. When you make an appointment at the hospital through Booking Health, the cost of treatment in Germany will be lower than if you contact the hospital directly. Prices are reduced due to the absence of additional taxes for foreign patients.
The Booking Health specialists will arrange your treatment in Germany. We will contact the hospital administration, book the nearest hotel to the hospital for you, buy airline tickets, and translate your medical documents into German. Our company's employees will also meet you at the airport, take you to the hospital, and provide interpreting services. After the completion of the treatment of your disease, you will be taken back 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:
European Society of Cardiology
