Traditional Tricuspid Valve Repair (open-heart Procedure) 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 ranks among the top German medical facilities specializing in the surgical treatment of cardiovascular diseases! The department offers the full service range in the field of cardiac surgery. Despite the fact that the department has long traditions, it has the reputation of one of the most high-tech Cardiology Centers in Europe. The clinical practice involves the use of achievements of modern surgery, particularly, minimally invasive and catheter techniques. Thus, cardiac surgeons achieve excellent results and at the same time guarantee the most sparing treatment and fast recovery for the patient.
Department of Adult and Pediatric Cardiothoracic Surgery
According to the Focus magazine, the Department of Adult and Pediatric Cardiothoracic Surgery ranks among the top German departments specializing in the surgical treatment of diseases of the cardiovascular system! The department offers the full range of surgical treatment of diseases of the heart, lungs, and other thoracic organs. The department has a long and successful history. It has performed more than 50,000 heart surgeries since 1938. The first open-heart surgery under hypothermia, the first heart valve replacement surgery, as well as the first pacemaker and cardioverter-defibrillator implantations in Germany should be mentioned among the department’s achievements.
Department of Congenital and Acquired Heart Defects, Heart Valve Diseases
The Department of Congenital and Acquired Heart Defects, Heart Valve Diseases offers the full range of diagnostics, outpatient and inpatient treatment of these diseases. The department became the first Center of Excellence in Germany in the field of its specialization and annually treats a large number of native patients and patients from other countries of the world. The department has a wide range of diagnostic options, as well as doctors have vast experience in catheter interventions. The department's medical team makes every effort in order to provide the first-class medical care adapted to individual needs. At the same time, important attention is paid to the psychosocial support of patients.
Tricuspid valve insufficiency (tricuspid valve regurgitation) is a common heart disease that is usually secondary and associated with mitral valve disease. The condition is associated with the enlargement of the cavities of the heart due to cardiovascular diseases. This heart disease repair usually requires surgical reduction of the annulus lumen and stabilization of its shape. You can have a surgical procedure to repair your heart valves at one of the German hospitals. You are welcome to use the Booking Health service to find out the cost of treatment in Germany and select the most suitable Cardiac Surgery Center.
Content
- What is tricuspid valve regurgitation?
- Indications for tricuspid valve insufficiency surgery
- Types of tricuspid valve repair to treat its insufficiency
- Why to undergo your tricuspid valve insufficiency treatment in Germany?
What is tricuspid valve regurgitation?
The tricuspid valve is located between the right atrium and the ventricle. It is required to pass blood only in one direction, that is, into the blood vessels of the lungs (pulmonary circulation), and then the valve must close and prevent blood from returning. If a hole between the chambers of the heart does not close completely, part of the blood flows in the opposite direction, and this phenomenon is called valvular regurgitation or insufficiency.
Tricuspid regurgitation can be:
- primary or secondary;
- isolated or combined with other heart defects, most often mitral insufficiency.
Up to 90% of cases involve secondary tricuspid regurgitation. This means that the valve itself is normal, but the hole that it needs to close has become too large. Up to 10% of cases are primary tricuspid regurgitation, which is caused by damage to the heart valve leaflets or their deflection into the atrium (prolapse) due to lengthening or tearing of the tendinous cords, which are the heart strings that hold the heart valve leaflets together.
The causes of secondary tricuspid regurgitation in most patients are heart diseases, such as valvular heart disease, dilated cardiomyopathy, and coronary heart disease. The primary form of the defect is usually associated with rheumatism, endocarditis, radiation therapy, and heart surgery.
Indications for tricuspid valve insufficiency surgery
Heart surgery may be required for patients in the following cases:
- severe tricuspid regurgitation if a patient has symptoms;
- a combination of moderate tricuspid regurgitation with mitral regurgitation or other heart diseases requiring surgical repair;
- the size of the patient's annulus fibrosus exceeds 4 cm when measured using echocardiography;
- the patient developed right ventricular heart failure.
Minimally invasive procedures for tricuspid valve repair are uncommon. These are occasionally used for high-risk surgical patients. The main treatment for this heart disease is open-heart surgery.
There are two types of operations: heart valve replacement surgery and heart valve repair surgery. About 90% of operations for tricuspid valve defects are surgical repairs. As a result, only 10% of patients undergo replacement surgery when the valve cannot be repaired.
Types of tricuspid valve repair to treat its insufficiency
How the tricuspid valve repair will be carried out depends on the characteristics of the heart disease. It is usually associated with the expansion of the annulus due to the enlargement of the cavities of the patient's heart, so the main method of valve repair is an annuloplasty.
In any case, open-heart valve repair surgery has the following three main goals:
- restoration or preservation of the mobility of the valve leaflets;
- providing a larger area of coaptation for the valve leaflets, that is, their contact when closing;
- stabilization, reduction, and improvement of the shape of the annulus fibrosus.
In 75% of patients, tricuspid valve insufficiency can be repaired with an annuloplasty. In 25% of cases, other stages of operations are required, which can be performed independently or in addition to the annuloplasty.
Suture annuloplasty. The DeVega operation, described in 1972, is considered a classic one. The procedure is performed by suturing the fibrous ring. The technique has many modifications. In any case, the essence of this operation remains the same: the fibrous ring is pulled together with sutures, so the heart valve area is reduced. The procedure is technically simple and can be performed quite quickly. This, however, has many disadvantages, the main one being that the results of the operation are short-lived. Many patients will require revision interventions in the future due to recurrent tricuspid regurgitation. Sutures reduce the size of the ring but do not restore it to its normal shape. This type of operation is sometimes used for moderate tricuspid valve insufficiency, and in Germany it was practically abandoned.
Annuloplasty with support rings. This surgical procedure is the main one for valve repair. Doctors use flexible or rigid rings. The soft ones are more commonly used. Their placement provides narrowing, fixation of the fibrous ring, and elimination of all defects. At the same time, the ring remains movable. It is fixed with U-shaped sutures, suturing it to the fibrous ring of the tricuspid valve. Physicians avoid suturing only the septal leaflet to avoid damaging the atrioventricular junction, which may lead to heart block.
Interventions on tendinous cords. This surgical option may be required for heart valve prolapse when the leaflets bend back into the atrium. In this case, the cords can be replaced, shortened, or shifted, depending on the situation.
Interventions on the leaflets. If the leaflets are damaged as a result of endocarditis or rheumatism suffered by the patient, they have to be repaired. Physicians close leaflet defects and sometimes practically shape new leaflets from the patient's own pericardium or use artificial patches. If the leaflets have come off the fibrous ring, they will be sutured. If volumetric formations appear on the valve leaflets, they will be removed with follow-up leaflet plastic surgery.
Why to undergo your tricuspid valve insufficiency treatment in Germany?
If you have tricuspid regurgitation, you can undergo your treatment in Germany. Doctors in this country use modern techniques for heart valve repair. Procedures and operations on the heart are performed by experienced specialists who have a high reputation not only in Germany but also far beyond its borders. German hospitals have state-of-the-art equipment that allows physicians to successfully perform even the most complex procedures and surgical interventions on the heart.
Treatment in Germany has the following benefits:
- new surgical modifications that allow for a close to normal shape of the heart valve ring and protection against future enlargement;
- stable results with a low risk of needing revision surgery;
- a low risk of complications, including heart block;
- patients' lethality is several times lower than the global average;
- successful medical treatment of even complex cases: tricuspid regurgitation caused by endocarditis, rheumatism, revision tricuspid valve surgery, or Ebstein's anomaly;
- several heart defects can be eliminated at once in one operation, while most often doctors perform concurrent repair of mitral insufficiency;
- the simultaneous treatment of several diseases at once is possible, for example, tricuspid valve plastic repair surgery and coronary artery bypass grafting;
- high-quality medical care and comprehensive recovery of patients after procedures and operations;
- comfortable conditions at German hospitals;
- an affordable cost of treatment in Germany relative to other countries with advanced medicine.
You can find out the cost of treatment in Germany and make an appointment for your medical treatment in Germany at the best price on the Booking Health website. Our website presents the best German hospitals. When you make an appointment through Booking Health, the cost of treatment in Germany will be lower than when you contact a Cardiac Surgery Center directly. The price is reduced due to the absence of high taxes for foreign patients.
The Booking Health specialists will arrange your trip abroad. We will select for you the best Cardiac Surgery Center that specializes in the treatment of heart defects and demonstrates excellent results. We will contact the administration of this center, schedule an appointment for your preferred dates, and translate your medical records into German. Our company's employees will also buy airline tickets and book a room at the nearest hotel to the Cardiac Surgery Center. The Booking Health specialists will meet you at the airport and take you to the hospital by car. After the completion of your medical care program, 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