Congenital & Acquired Heart Defects (EMAH)

Special focus

PATIENTS WITH CONGENITAL HEART DEFECTS
Care is provided for patients with the complete range of congenital heart defects which have been surgically or catheter-interventionally corrected, partially corrected or have not been corrected. Special attention is given to the timely planning of initial procedures or repeated procedures (operations or catheter intervention) through extensive diagnosis as well as their ultimate execution. In addition, all chronic complications (cardiac insufficiency, arrhythmia, pulmonary hypertension, etc.) as well as acute complications are clarified and treated (arrhythmia, endocarditis, various vascular complications, etc.) The spectrum includes the following symptoms:
  • obstructive heart defects: valve stenoses (aortic, bicuspid, pulmonary and tricuspid valves), supravalvular and subvalvular stenoses as well as stenoses within the ventricles of the heart, stenoses of the large vessels (e.g. aortic coarctation)
  • cardiac valve insufficiencies
  • simple shunt vitia: open foramen ovale, atrial septal defect, ventricular septal defect, patent ductus arteriosus, and others
  • complex heart defects: tetralogy of Fallot, transposition of the large vessels (completely or congenitally corrected), tricuspid, pulmonary, mitral atresia, Ebstein’s anomaly, heart defect with only one functioning ventricle (univentricular hearts), status post Fontan Operation
PATIENTS WITH ACQUIRED HEART DEFECTS, INCLUDING THE FOLLOWING SYMPTOMS:
  • aortic valve stenosis: quantification, preoperative diagnosis incl. a cardiac catheter, in the case of a corresponding indication also interventional aortic valve implantation (transfemoral or apical)
  • transcatheter implantation of the Edwards-Sapien® valve in pulmonic position
  • mitral and tricuspid valve insufficiency: diagnosis in the case of primary, morphologically changed valvular defects (e.g. prolapse) or secondary valvular dysfunctions in the case of infarct, dilatative cardiomyopathy, right ventricular disease and others, quantification by means of echocardiography, preoperative diagnosis incl. a cardiac catheter; in the planning stage: in the case of a corresponding indication, interventional treatment of mitral insufficiency with the MitraClip®-procedure and also interventional LAA occlusion
  • endocarditis therapy
  • evaluation of postoperative results and complications as, for example, a dysfunction of artificial cardiac valves
GENERAL OVERVIEW OF DIAGNOSTIC AND THERAPEUTIC PROCEDURES
A broad diagnostic range of non-invasive procedures is available, including echocardiography (transesophageal and transthoracic including tissue Doppler echocardiography, strain-rate-based representations, as well as three-dimensional echocardiography), long-term ECG and stress ECG, 24-hr. blood pressure measurement, stress tests (ergometry and spiro-ergometry), cardiac magnetic resonance tomography, as well as dual-source computer tomography (together with the Institute for Clinical Radiology). The following invasive procedures are performed:
  • diagnosis: left and right heart catheters using biplanar fluoroscopic techniques and rotational angiography
  • catheter interventions: occlusion of patent foramen ovale, occlusion of atrial septal defects, occlusion of patent ductus arteriosus, balloon dilation (valvuloplasty) of cardiac valves (the pulmonary, mitral, and tricuspid valve and the aortic valve), catheter implantation of aortic valve prostheses (transfemoral or apical), balloon dilation and stent implantation of constricted vessels, occlusions of unwanted anastomoses.
  • rhythmological treatment, including defibrillator therapy, especially in the case of arrhythmia in connection with congenital heart defects (e.g. atrial flutter, ventricular arrhythmia) including electrophysiological diagnosis and therapy (through the Department of Rhythmology under its Director, Prof. Eckardt, MD)
  • If required, our colleagues in cardiac and thoracic surgery can also provide surgical treatment.