Department of Adult and Pediatric Cardiothoracic Surgery - University Hospital Saarland Homburg

About the Department of Adult and Pediatric Cardiothoracic Surgery at University Hospital Saarland Homburg

The Department of Adult and Pediatric Cardiothoracic Surgery at the University Hospital Saarland Homburg offers the full range of services in this medical field and specializes in providing top-class medical care to patients with diseases of the heart, lungs, and aorta. Cardiothoracic surgeons treat patients of all age groups, ranging from young children to the elderly. The primary focus of the doctors' work at the medical facility is the treatment of aortic and mitral valve regurgitation, with the specialists aiming to perform a reconstructive intervention rather than heart valve replacement surgery. Doctors have vast experience in coronary artery bypass grafting. The department is one of the few medical facilities of this kind in Germany, where doctors offer endarterectomy for chronic pulmonary embolism. The department has modern medical equipment and competent staff, which guarantees excellent medical care as well as a friendly and responsive attitude towards patients. The department performs more than 1,600 surgical interventions of varying complexity, and more than 2,200 patients receive medical care on an outpatient basis. The Head Physician of the department is PD Dr. med. Gloria Färber.

Many patients seek medical attention from the department with complex cases of coronary heart disease, the main surgical treatment for which is coronary artery bypass surgery. The essence of the operation is to form a blood flow bypassing the narrowed coronary blood vessel, as a result of which the normal blood supply to the heart will be restored. The veins of the lower limbs are usually used as bypass material. In patients over the age of 70, the department's cardiac surgeons most often use arteries for coronary artery bypass surgery since this group of patients often suffer from varicose veins, and bypass surgery using the veins of the lower limbs cannot provide a long-term result. The department's specialists offer their patients both minimally invasive and open surgical techniques for coronary artery bypass grafting. Open surgery requires a traumatic thoracotomy but, in many cases, this intervention provides the best results. The department mainly performs CABG operations with the use of a heart-lung machine. If a patient has contraindications to its use, surgery will be performed on a beating heart. 

An integral part of the department's clinical activity is the surgical treatment of pathologies of the aortic and mitral valves such as stenosis and regurgitation. Whenever possible, the team of cardiac surgeons strives to repair the affected heart valve, thus preserving the patient's own heart valve. However, in many clinical cases, patients still require surgery to replace the aortic or mitral valve. The optimal treatment method is determined for each patient individually. Patients with severe aortic valve stenosis are advised to have surgery to replace it with a biological or mechanical prosthesis. Each of the artificial heart valves has its own advantages and disadvantages. Biological prostheses are made from specially processed animal tissue (porcine heart valve tissue or bovine pericardial tissue). The main advantage of using such a heart valve is the absence of the need for the long-term use of anticoagulants, but there are also disadvantages, namely a relatively short service life and the need for revision replacement surgery in the future. The department's cardiac surgeons most often implant biological prostheses in patients older than 50 years. In this case, their service life is 10-20 years, and it does not exceed 10 years for young people. The service life of a mechanical prosthesis can reach 40 years, which is the main advantage of choosing this type of artificial prosthesis. There are also disadvantages, however, including lifelong use of anticoagulants, which, in turn, may provoke bleeding. In addition, patients who have had mechanical prosthesis implantation surgery are at an increased risk of developing endocarditis (a bacterial inflammatory process), which often requires revision surgery and antibiotic therapy.

Cardiac surgeons admit young patients with congenital heart disease. The competence of doctors includes the surgical repair of common and especially complex defects. Young patients are monitored in cooperation with pediatric cardiologists. The specialists make every effort to detect a heart disease in a child as soon as possible and to provide the necessary treatment to avoid future health issues.

The department's specialists have successful experience in performing pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension. The pathology is a severe and rare form of pulmonary hypertension that occurs due to chronic obstructive pulmonary disease and secondary changes in the lung microvasculature. Pulmonary thromboendarterectomy is considered a complicated surgical procedure, and it is not available in all medical facilities in Europe. The aim of the surgery is to remove blood clots from the pulmonary arteries. The operation is performed under general anesthesia with the use of a heart-lung machine, and a thoracotomy is also required.

In the field of thoracic surgery, the department regularly performs all types of surgical interventions on the lungs and mediastinal organs. Of particular interest is lung cancer surgery. In the early stages of the oncological process, the department's thoracic surgeons mostly manage to perform sparing treatment with video-assisted thoracoscopic surgery. Lung cancer surgery is usually complemented by conservative treatments, including chemotherapy, radiation therapy, and/or chemoradiotherapy. Pulmonologists, oncologists, radiation therapists, radiologists, and doctors from other related medical disciplines are actively engaged in the therapeutic process.

The department's main clinical activities are as follows:

• Heart surgery
  • Coronary artery bypass grafting: classic open and minimally invasive techniques
  • Aortic and mitral valve repair in the case of their stenosis or regurgitation
  • Aortic and mitral valve replacement surgery in the case of their stenosis or regurgitation
  • Surgical treatment of congenital heart disease in children
  • Heart tumor surgery
  • Heart transplant and heart-lung transplant
• Thoracic surgery
  • Prosthetic repair of the thoracic and thoracoabdominal aortic portions
  • Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension
  • Surgical interventions on the lungs and mediastinal organs with a special focus on lung cancer surgery
    • Atypical lung resection
    • Segmental lung resection
    • Lobectomy
    • Pneumonectomy
  • Pleurolysis
  • Mediastinoscopy
  • Pleurectomy
  • Pleural drainage 
  • Lung transplant and heart-lung transplant
• Other medical services