Aortic surgery in Germany

Aortic surgery is performed in case of aortic aneurysm, which is an unusual bulge occurring in the wall of aorta that carries blood from your heart to other vital organs in the body. Aortic aneurysms are of two types, tube-shaped (fusiform) and round (saccular). Aortic aneurysms are also categorized on their location along the aorta.
  • Abdominal Aortic Aneurysm
  • Aortic aneurysm occurring along the part of aorta passing through the abdominal region is classified as abdominal aortic aneurysm.
  • Dissecting Aneurysm
  • Dissecting aneurysm or aortic dissection is a tear that develops along the inner layers of the aortic wall. This condition results in the separation of the aortic layers, thus weakening the aortic wall.
  • Thoracic Aortic Aneurysm
  • Thoracic aortic aneurysm occurs along that part of aorta which runs through the chest cavity.

Why choose Germany for receiving treatment for aortic aneurysm?

The highest level of heart treatment in Germany with trained specialists in blood vessel surgery, heart surgery, blood vessel and heart conditions are competent in treating aortic aneurysms along with other vascular conditions. Each of the specialized cardiac treatment centers in Germany has a well equipped vascular center, have competent doctors and other specialists well trained in delivering effective vascular treatments.

Working in a team, the efficient cardiac specialists in Germany can evaluate your aortic condition and develop effective treatment plans, often within a matter of few days. With the aid of latest diagnostic tools and a set of detailed imaging tests like computerized tomography (CT), echocardiography, magnetic resonance imaging (MRI), etc. an accurate diagnosis of aortic aneurysms is possible almost instantly.

Being the pioneers in research and innovative techniques for treating aortic aneurysms, the expert German cardiologists have expertise in treating people using open surgery, endovascular surgery and such other treatment procedures. With our extensive database of the expert doctors competent in performing heart surgery in Germany, we will help you select the best medical centers for cardiology in Germany to receive your medical treatment when you arrive here.

Treatment Procedures with Aortic Aneurysms

Aortic surgery becomes a necessity when aneurysms occur in the ascending aorta and the aortic arch has an increased frequency. Other cases like a fold leak in aorta or the buckling risk in which the traverse diameter of aorta increases up to 5cm also needs a surgical treatment.

The surgical procedures carried out are decided by the extent as well as specific location of aneurysms along the aorta. Aneurysms are treated with inconspicuous aortic valve and the normal aortic root by using some specific plastic prostheses. The aortic arch can also be replaced using this technique.

The gentler and the interventional positioning of the prostheses are becoming popular over the operational methods used in treating aneurysms in descending aorta. During the process, the catheter through the artery makes a beck around the aneurysm and is placed on the tears and thus releases the prosthesis. This prosthesis is anchored well on both, the upstream and the downstream of the aneurysms and on that particular area where the descending aorta is diseased. A number of prostheses can be used in a course as required. The same application can be used to treat an acute tear or a descending aorta.

Recent Trends in Abdominal Aortic Aneurysms

The recent studies have shown that endovascular repairs have a low complications rate and can even be performed in high-risk patients such as those suffering from heart, kidney and lung problems. These minimally invasive procedures are showing good results in treating abdominal aortic aneurysms. Clinical trials connected with cardiac surgery in Germany have shown that endovascular repairs can be done even when aneurysms are ruptured and these procedures have a low level of mortality rate in comparison with open-abdominal surgery.

The endovascular surgery has a typical recovery period of a day in the hospital followed by a week or two weeks’ rest at home. In cases of open-abdominal surgery, the recovery time will be five to seven days in the hospital followed by four to six weeks of rest at home. During the last decade, endovascular repairs are gaining more popularity over open-abdominal surgical procedures. Of all the aortic aneurysms treatments conducted on patients both with life threatening symptoms and some common symptoms, the endovascular repairs have been rewarding with a low mortality rate and low rates of complications.

Based on aortic registry, the analytical data and the studies conducted between 1997 and 2011 also reveal that aneurysms are more prevalent in men than in women. The complications with these treatments include blood clots, post-operational bleeding and such other problems with repair. However, the survival rates after an operation were higher than 50% in patients even with high risk factors and up to 74% in low-risk patients. People addicted to smoking, people with high cholesterol and/or high blood pressure and people with a family history of aneurysms should undergo abdominal ultrasounds after an age of 55 to diagnose for possible occurrences of aneurysms.

In all the cases, with well sorted out information on the most competent cardiologists, we will help you get the best available treatments regarding cardiac surgery in Germany.

Mitral valve repair in Germany

Mitral valve is the valve present in between your left atrium and left ventricle and performs the function of an “inflow valve”. Mitral valve repair is one of the open heart surgical procedures performed to treat problems related to mitral valve. The problems in mitral valve could be of two types. In mitral valve regurgitation, the flaps of the mitral valve get weakened and results in blood leaking back to the left atrium. If untreated, this condition can damage your heart muscles. The other problem is stenosis, which is caused due to the narrowing of the mitral valve.

The standard of cardiology in Germany is one of the best in the world. German hospitals have experienced cardiologists and cardiovascular surgeons well versed in assessing the problems related to mitral valve and treating heart and blood vessel conditions. German heart specialists are experts in diagnosing mitral heart disease with a range of tests like cardio catheterization, echocardiogram, chest-X-ray and such others. Cardiac surgery in Germany is safe, as the German cardiologists conduct regular researches about new diagnosis and innovative treatment options for various heart related diseases. With an expertise in treatment procedures like mitral valve repair, mitral valve replacement, balloon valvotomy and other heart valve surgical procedures, the efficient German cardiologists will offer you an excellent heart treatment in Germany. We have an extensive data-base of the most efficient and competent cardiology specialists and lend you a helping hand in receiving the best available heart treatment in Germany.

For many years, the replacement of mitral valve was the standard technique to treat a patient suffering from mitral valve disease. The replacement was done with an artificial mitral valve and the procedure had many downslides. The replacement procedure often resulted in the infection of the prosthetic valve, this is a dangerous situation. Patients with artificial heart valves need to take blood thinners although the rest of their lives, there is a high risk of bleeding complications as well. These artificial valves last up to 15 years and the patient has to undergo the risk of a second replacement after this period. Apart from these complications, an artificial mitral valve poses you a significant risk of stroke (approximately 1% each year).

Cardiology in Germany- Recent Trends

During the last two decades, cardiac surgeons have resorted to a much safer option of mitral valve repair over mitral valve replacement. Over 65% of the cases with mitral valve disease are now treated with mitral valve repair. This procedure has been gaining much popularity since 2003 and the trend has been marching ahead as seen in the figures for 2012.

There has been a constant increase in the minimal invasive procedures in treating problems with mitral valve. In these procedures, the sternum is spared from any cuts. But, the operation is done through a small incision. These minimal invasive procedures, which amounted to only about 13% of the total mitral valve treatment procedures in 2006, have seen a significant rise amounting to about 41% as in 2011. One could observe that these procedures are becoming popular as there is a whopping rise of over three folds in their numbers.

Mitral valve repair procedure has a lower mortality risk rate in comparison with mitral valve replacement. Figures revealed in 2011 show that while the mortality risk with mitral valve repair was 1.8%, the risk involved with mitral valve replacement was much higher at 9.5%. The surgical procedure is not the only cause that is resulting in such higher rates of mortality, but the severity of mitral valve disease itself is elevating the higher mortality risk rates. In most of the cases, mitral valve repair can be opted instead of valve replacement.

In addition, the recent years have seen a new procedure in mitral valve repair which involves inserting a clip by catheter. In this process, the chest is not opened; instead the clip is advanced through the blood vessels and to the heart. This process is not about restoring the mitral valve in an anatomical sense, but to get rid of any leaks of the mitral valve. The procedure involves stringing a staple on both of the mitral valve leaflets with a clip. This is done as a supplement to a customary mitral valve surgery. This is much common while treating very sick and elderly aged patients who cannot withstand high risks associated with conventional reconstructive surgical methods and an anatomy of mitral valve. This is a unique and an innovative non-invasive surgical method, but very few patients can be benefitted from this method.

The standards of heart surgery in Germany are excellent, but the costs of mitral valve repair in Germany are much lower than in most of the developed countries. The costs include expenses on medicine, the stay at the hospital, anesthesia, surgeon’s and anesthesiologist’s fee, operation room fee, medical expenses, nursing, pre-operative diagnosis, semi-private room, meals, local phone and for TV as well. With our vast experience and expertise, we will be guiding you through to receive the best available cardiac treatment in Germany.

Off-Pump-Coronary-Artery-Bypass in Germany

OPCAB or the “beating-heart” surgical procedure is performed to treat coronary artery disease (CAD). In this process, a coronary artery bypass graft or CABG is executed without the help of a cardiopulmonary bypass (cardiopulmonary machine). While performing most of the bypass surgeries, the patient’s heart is made to stop and an external cardiopulmonary machine performs the work of heart as well as lungs. A cardiac surgeon performs the CABG off-pump procedure, also called OPCAB while the heart still beats and the graft add-ons are made to bypass the blockage.

OPCAB procedure has been developed partly to overcome the complications of cardiopulmonary bypass during a cardiac surgery. There is a belief among the medical community that cardiopulmonary bypass leads to a cognitive declination following the operation, which is known as Post-Perfusion Syndrome (informally known as “pumphead”). However, research has shown that there is no difference in a long-term as such among the low-risk patients who undergo on and off-pump coronary arterial bypass procedures. The reason behind this could be that the pump could not be the main cause for brain damage; instead an embolic process described below could be the real problem.

The fatty type material that gets collected to form a blockage or debris on the linings of the arterial walls may break loose when CABG procedures are performed. This debris material can cause clots or ‘emboli’ that interrupt regular blood flow to the brain. This could lead to neurological damage or even stroke in some cases. Analysis conducted with data collected from OPCAB (beating heart surgery) patients reveals that there is a significant reduction in the release of such debris material in them and also show a considerably lower rate of stroke risk.

The fatty debris matter leading to emboli that cause brain damage are mostly generated when the aorta is manipulated during a coronary bypass surgical procedure. Even in cases where OPCAB procedures are performed, these particles are not eliminated as aorta is still being used as a base to attach grafts to open up the constriction. To avoid these drawbacks, most of the OPCAB surgeons have now resorted to avoid aorta completely and perform a coronary bypass surgical procedure (Anaortic) by shifting all the grafts from sites other than aorta, such as internal mammary arteries. This procedure results in a low stroke risk, which is even lesser than what is seen in procedures like percutaneous coronary intervention.

OPCAB procedures are not only associated with clinical benefits of a much reduced risk of stroke and memory problems in patients undergoing them, they also have a faster recovery rate and stay in the hospital for a much shorter period. They need a fewer blood transfusions, experience fewer of the unwanted inflammatory and immune response complications. Such are the advantages of OPCAB procedures and we can help you chose the best medical facility centers for Off-pump Coronary Artery Bypass (OPCAB) in Germany from our extensive data base consisting of some of the expert doctors and super specialty medical care centers for cardiology in Germany.

Non-Invasive and Direct Coronary Artery Bypass

If you are looking for heart treatment in Germany, you must be aware of the clinical benefits of MIDCAB in Germany. MIDCAB is a less invasive CABG surgery procedure involved in the treatment of coronary heart disease. MIDCAB is done by gaining a surgical entry into the heart by a much minor incision than most other CABG procedures. MIDCAB for this reason is called as “Keyhole” cardiac surgery as the entire operation is performed through the small incision much similar to how a key is operated within the keyhole.

MIDCAB is also a type of OPCAB procedure but it is different from OPCAB in the form of incision made while conducting the surgery. With traditional OPCAB procedures the CABG is done through the median sternotomy that divides the breastbone and gives an access into the heart. With MIDCAB procedure, the surgeon gains access to the heart through a minor thoracotomy, just 2 to 3 inches of incision created among the ribs.

MIDCAB procedures are no longer just the remedy for diseases with anteriorly located single or dual vessel. Lesions like in MIDCAB are also administered in angioplasty treatments and hence these procedures are also being used in treating multi-vessel diseases.

With excellent facilities for cardiac health care, opting for heart surgery in Germany is always a safe choice. The expert German doctors are pioneers in research and adopting innovative techniques related to complex cardiac surgery procedures. They are actively involved in many clinical trials and are constantly on a look out for latest treatments for coronary artery heart diseases. With our expertise in the field of medical assistance, we can always help you get the best possible medical services related to cardiac surgery in Germany.

Stenting in Germany

For patients with cardiovascular conditions that do not respond to medications and lifestyle changes, stenting is often an ideal form of treatment. Cardiologists may also recommend stenting to open up a blockage in heart, reopen constricted carotid arteries that could lead to stroke, and to expand narrowed arteries supplying blood to arms and legs. Stenting involves implanting or deploying a tiny metal tube or stent within an artery, or a blood vessel to hold it open with the help of a balloon catheter.

The stents for treating coronary artery disease are implanted in laboratories where cardiac catheterization is undertaken. During the process, the blood vessel is made to expand with the help of a balloon catheter at the narrowed point and the constriction is thus eliminated.

The stent to be implanted is mounted upon the balloon and inserted into the blood vessel through the catheter and moved on to the constricted site. Here the balloon-catheter aids the stent to be dilated and made to support the blood vessel so that the constriction is removed permanently and the blood vessel is kept open for a free flow through it.

As the stent is made to pass through the blood vessel and implanted in the desired position to stay there, there is every chance that blood platelets stick to the stent as they consider it as foreign substance. This process can again lead to constriction and the blood vessel could be narrowed down. To avoid such a situation, the patients undergoing stenting procedures are advised to take in medications that inhibit platelet aggregation on the stent. Stent need not be placed in the blood vessel for too long, but only for a certain period. Therefore, in current clinical trials stents made of self-dissolving materials are being used. Such stents are called as bio-absorbable stents; stents made using magnesium are dissolved within nine or ten months after implantation. These scaffolds do not remain within the blood vessel for the entire life but only during the process of healing.

Benefits of Stenting:

Like angioplasty, stenting is also a minimally invasive procedure performed as an alternative to CABG surgery. Risks associated with stenting are much lower than what we come across in CABG procedures. Patients opting for this method of treatment have a shorter recovery time and can normally move home the very next day after the procedure is completed. They can perform their normal daily activities within a short period of time. In addition to the above said benefits,
  • You do not require any major surgery, only a small incision is enough
  • Lesser discomfort and most of the patients even do not need a general anesthesia
  • There are no major complications
Stenting has no major complications, however, this procedure carries the general risks as found with angioplasty while treating a coronary heart disease. The site of insertion of the catheter can get infected, bleed heavily and is likely to be bruised. The rare complications with stenting include stroke, heart attack and an unexpected cardiac death. However, all these complications occur at lower rates than with CABG.

Coronary artery, even after stenting can get re-narrowed, this is observed in 15-30% of the patients depending on the nature of the stent. This tendency is low in patients who are implanted with drug-eluting stents. If restonosis or re-narrowing occurs, the patient has to again undergo a stent procedure, balloon angioplasty, or even a bypass surgery.

The other complication is a rare phenomenon called as stent thrombosis. As discussed earlier, administering of anti-clogging medications as long as your cardiologist suggests you is the remedy for this problem.

Stenting can be considered appropriate:
  • If you have a new obstruction even after undergoing an angioplasty
  • An artery blockage in excess of 50%
  • A past history of mini-stroke, stroke or vision loss in one eye
  • With conditions like severe lung or heart disease, kidney failure, neck operations in the past and tumor radiation in neck
  • Narrowing of the arteries that are too difficult to be accessed with surgical procedure
With high-class medical facilities for cardiology in Germany and German cardiologists being the pioneers in vascular and neurosurgical procedures, they are well versed in performing complicated cardiac and vascular procedures like stenting and carotid angioplasty to treat diseases concerned with coronary artery. Stenting may be a relatively new procedure, but German doctors and cardiologists have studied many clinical trials and have already treated many patients successfully as well.

With all the expertise and sophisticated health care facilities, opting for cardiac surgery in Germany is always a safe choice. Heart surgery in Germany is followed up by expert cardiac rehabilitation facilities that help patients resume their daily activities within a short span of time; know more about cardiac risks and receive psychosocial support. Studies reveal that patients who participate in these rehabilitation programs are better of with managing cardiac risks and live a longer life. We will help you with credible assistance in selecting the best and competent cardiology health care centers if you are seeking heart treatment in Germany.