Department of Cardiac Surgery and Heart Transplantation - University Hospital Erlangen

About the Department of Cardiac Surgery and Heart Transplantation at University Hospital Erlangen

According to the Focus magazine, the Department of Cardiac Surgery and Heart Transplantation at the University Hospital Erlangen 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.

The department is headed by Prof. Dr. med. Michael Weyand. The cardiac surgeon has more than 26 years of successful clinical experience and brilliantly performs even the most complex cardiac interventions, returning patients with severe heart pathologies to a full life.

The department performs about 1,600 operations on the heart and large vessels annually. About 1,100 of these operations are performed with the use of a heart-lung machine, on an open heart. The surgical interventions are performed in 3 operating rooms equipped with state-of-the-art technology. A team of surgeons is always available in the department to provide around-the-clock emergency treatment of heart diseases.

The department's doctors perform heart surgeries using the very latest techniques to avoid blood transfusions. Whenever possible, the patient's own blood is collected before surgery. Special hemostatic medications are also used (for example, tranexamic acid). After the operation, the blood undergoes special treatment and is injected back to the patient, due to which about half of all interventions in the department are carried out without the use of donated blood.

Coronary artery bypass grafting is one of the most demanded heart interventions. The department's specialists regularly perform various types of coronary artery bypass grafting in patients with coronary heart disease, which develops due to the narrowing of the lumen of the coronary vessels and insufficient oxygen supply to the myocardium. Diagnostics based on electrocardiography and coronary angiography play a decisive role in the treatment success of a pathological condition. At the early stages of coronary heart disease, drug therapy or balloon dilatation is provided, and if, according to the results of the examination, the doctor confirms the advanced stage of the pathology, the only effective treatment method is coronary artery bypass grafting. The department uses various modifications of the surgical intervention, including minimally invasive one and without the use of a heart-lung machine, but the classical version of the operation is still the most common. The operation is performed under general anesthesia, using a heart-lung machine and thoracotomy. The essence of the intervention is to restore blood flow in the coronary arteries by bypassing the area of vasoconstriction with an autologous graft. The material for grafts is taken from the internal thoracic artery, radial artery, or great saphenous vein of the lower limb. The duration of the intervention is about 3-4 hours. After coronary artery bypass grafting, the patient requires cardiac rehabilitation to fully recover.

Heart valve interventions are also within the department's competence. The medical facility deals with the treatment of both congenital and acquired diseases of this spectrum, while aortic and mitral valve pathologies are most common. The department's surgeons successfully correct stenosis and heart valve insufficiency, including combined defects (simultaneous damage to several heart valves). The key diagnostic methods are echocardiography (heart ultrasound) and cardiac catheter examination. Should the diagnosis be confirmed, depending on the degree of damage to the valve, a decision is made on the optimal type of surgical intervention – valve reconstruction or replacement. To replace the valve, the department's cardiac surgeons use mechanical and biological prostheses. Which prosthesis is best suited for a particular patient is determined by the attending surgeon, based on clinical data, the type of valve defect, the patient's age and the presence of comorbidities. Each of the prostheses has its own advantages: the service life of a mechanical prosthesis is practically unlimited, but a patient with an artificial valve will have to take anticoagulants for life; the service life of the biological valve is no more than 15 years, after which it has to be replaced, but after the implantation of this type of prosthesis, there is no need to take anticoagulants. Today, the department's team of surgeons performs effective minimally invasive operations to correct heart valve defects, which do not require thoracotomy. Due to this, the risks of developing postoperative complications are practically close to zero, and the patient's recovery after the intervention occurs as soon as possible. The most common of these are transcatheter aortic valve implantation (TAVI) and the MitraClip procedure for mitral valve insufficiency.

Another leading area of ​​work of the department's doctors is heart transplantation. Such operations are performed only in progressive medical facilities with an advanced level of technical equipment and highly qualified cardiac surgeons. The main indication for a heart transplantation is a severe form of heart failure, which cannot be corrected with other therapeutic methods, and which poses a danger to human life. Obviously, before such a serious operation, not only the heart is examined, but also the whole body of the patient. If, during an interdisciplinary board, the department's specialists come to the conclusion that a patient is a candidate for an intervention, he is registered in the Eurotransplant program. The patient then officially becomes a donor heart candidate and is placed on the waiting list for heart transplantation. It usually takes several months to find a suitable donor organ. Heart transplantation is performed using a heart-lung machine and thoracotomy. After the intervention, the patient stays in the department, under constant monitoring of medical personnel, and receives the necessary drug therapy to prevent transplant rejection. The patient then undergoes cardiac rehabilitation and regular examinations to monitor the condition of the new heart.

The department's range of medical services includes:

• Coronary artery bypass grafting (including minimally invasive techniques and beating heart surgery)
• Classical heart valve surgery (implantation of mechanical and biological valve prostheses)
• Minimally invasive heart valve surgery
• Heart valve interventional procedures on a beating heart
• Surgical treatment of thoracic aortic aneurysms
• Implantation of mechanical heart support systems (artificial heart)
• Heart transplantation
• Pacemaker implantation
• Defibrillator implantation
• Treatment of congenital heart defects in adults
• Other therapeutic options