Surgical treatment for coarctation of the aorta with subclavian flap aortoplasty in Charite University Hospital Berlin

About the department

According to the Focus magazine, the Department of Cardiac Surgery at the Charite University Hospital Berlin 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.

The Head Physician of the department is Prof. Dr. med. Volkmar Falk. The surgeon has exceptional experience in his area of specialization and saves the lives of patients with severe heart disease. In addition to his clinical practice, Prof. Falk devotes a great deal of time to scientific research, which has resulted in successful research projects and more than 700 scientific publications. The doctor is a Member of the German Society for Thoracic and Cardiovascular Surgery (DGTHG), the European Association for Cardio-Thoracic Surgery (EACTS), and other professional societies that set global standards for the surgical treatment of heart disease.

Heart valve surgery is of particular clinical interest to the department's team of cardiac surgeons. Patients with aortic, mitral, and tricuspid stenosis and insufficiency are operated on here. The optimal type of surgical treatment for the patient is selected after a comprehensive cardiologic evaluation, based on the severity of the disease, the severity of symptoms, and existing risks. Patients with aortic valve stenosis are offered aortic valve replacement surgery using traditional open techniques and the interventional TAVI procedure, transcatheter aortic valve implantation. Whenever possible, TAVI is preferred, which is performed through a femoral artery puncture using catheter-based techniques under local anesthesia. Minimally invasive aortic valve replacement is also performed here without sternotomy. The department's range of services also includes operations for mitral valve stenosis and regurgitation. Cardiac surgeons perform the majority of mitral valve repairs: in 90% of cases, specialists perform repair procedures that allow the patient's own mitral valve to be preserved and its function restored. The department performs more than 400 mitral valve repair procedures each year, so the specialists have extensive experience in this area. Cardiac surgeons at the medical facility are also highly competent in performing minimally invasive procedures to treat tricuspid stenosis and regurgitation.

Surgical treatment of coronary artery disease (CAD) occupies an important place in the clinical practice of the department's physicians. This cardiopathology is associated with impaired blood supply to the heart muscle due to damage and narrowing of the coronary arteries in atherosclerosis. In the advanced stages, CHD may lead to the development of acute coronary syndrome, a life-threatening condition. In addition, if left untreated, CHD may cause the development of secondary cardiac pathologies, such as heart failure or heart rhythm disturbances.The cardiac surgeons of the department specialize in the treatment of CHD through catheter-based interventions and traditional open surgery: in the first case, percutaneous transluminal coronary angioplasty with or without stenting is performed through the femoral or radial artery under angiographic guidance, and in the second case, coronary artery bypass grafting is performed. When clinically indicated, the department's specialists perform aortocoronary bypass surgery using minimally invasive techniques (without a sternectomy) and on a beating heart (without the use of a heart-lung machine). Each clinical case is unique, and in order to select the optimal treatment option, the cardiac surgeons, together with the cardiologists, study the patient's medical history and diagnostic data in detail.

Another clinical priority for the medical facility is the catheter-based and surgical treatment of cardiac arrhythmias: bradycardia (slow heartbeat) and tachycardia (fast heartbeat), including supraventricular tachycardia and ventricular tachycardia. The first-line treatment for tachycardia is drug therapy. If this fails, radiofrequency catheter ablation is considered as a second-line treatment: the essence of the procedure is a thermal effect on arrhythmogenic areas of the heart. In patients with ventricular tachycardia, implantation of an implantable cardioverter defibrillator is often indicated, since this type of arrhythmia carries a high risk of sudden cardiac death. The department successfully performs transvenous and subcutaneous defibrillator implantation procedures. These procedures are performed using minimally traumatic catheter-based techniques, which is a great advantage for the patient because in this case the risks are practically zero. In most cases, drug therapy and lifestyle modification are sufficient to normalize the heart rhythm in bradycardia, but in complex clinical situations, the only effective treatment option is the implantation of a pacemaker. These procedures are also performed in the department in the cardiac catheterization laboratory.

As a maximum care medical facility, the department guarantees each patient effective treatment adapted to their clinical case. Heart surgery is often anxiety-provoking for patients, so cardiac surgeons spend a lot of time in consultations, explaining the procedure, what to do afterward, and what to expect. This helps the patient to cope with the stress and to tolerate the treatment well.

The department's medical services include the following options:

• Catheter-based and surgical treatment of heart valve disease
  • Treatment of aortic valve pathologies
    • Catheter-based treatment of aortic valve stenosis using transcatheter aortic valve implantation (TAVI)
    • Minimally invasive aortic valve replacement surgery
  • Treatment of mitral valve pathologies
    • Minimally invasive mitral valve repair surgery
    • Minimally invasive mitral valve replacement surgery
  • Treatment of tricuspid valve pathologies
    • Minimally invasive tricuspid valve repair surgery
    • Minimally invasive tricuspid valve replacement surgery
• Catheter-based and surgical treatment of coronary heart diseases
  • Treatment of ischemic heart disease
    • Percutaneous transluminal coronary angioplasty with or without stenting
    • Coronary artery bypass grafting, including minimally invasive and without the use of a heart-lung machine
  • Treatment of myocardial infarction
    • Percutaneous transluminal coronary angioplasty with or without stenting
• Catheter-based and surgical treatment of aortic pathologies
  • Surgery for acute conditions
    • Surgery for type A aortic dissection
    • Surgery for penetrating aortic ulcer
    • Surgery for aortic intramural hematoma
    • Surgery for traumatic or iatrogenic aortic ruptures
    • Surgery for acute inflammatory processes with aortic involvement
  • Surgery for chronic aortic pathologies
    • Surgery for arteriosclerosis
    • Surgery for thoracic aortic aneurysm
    • Surgery for chronic aortic dissection
  • Surgery for aortic lesions associated with genetic diseases: Marfan syndrome, Turner syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome
• Catheter-based treatment of cardiac rhythm disturbances (arrhythmias)
  • Catheter-based procedures for tachycardia
    • Radiofrequency catheter ablation
    • Transvenous and subcutaneous implantable cardioverter-defibrillator placement
  • Catheter-based procedures for bradycardia
    • Pacemaker implantation
• Catheter-based and surgical treatment of arterial hypertension
  • Balloon dilation and stenting for renal artery stenosis
  • Surgical removal of hormone-producing tumors (in collaboration with specialized surgeons)
• Other medical services