Heart Surgery – Nuremberg Hospital

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Senior Physician: Prof. Theodor Fischlein, MD
Phone: +49 911 398 5441

The Department for Heart Surgery offers all procedures for modern adult heart surgery. Per year, approx. 1000 heart operations are performed in Nuremberg.

Range of services
	Bypass surgery
	Valve replacement operations
	Preserving the patient's own heart valves
	Mitral diseases
	Operations to the aorta
	Cardiac insufficiency
	Doctors
	After surgery

Coronary bypass surgery consists of the revascularisation of the coronary vessels using the body's own arteries and veins, with purely arterial revascularisation growing increasingly significant. Operations are usually performed using the heart-lung machine, although in certain situations it is possible to manage without extracorporeal circulation. In individual patients, bypass surgery without the heart-lung machine is a more gentle method with fewer potential risks.

Patients with considerably reduced heart rate (EF < 30%) suffering from coronary heart disease present a special challenge. Several clinical studies have verified that these patients in particular profit from heart surgery generally with a clear improvement in heart rate and quality of life. In these patients, a balloon pump is pushed into the aorta through the groin one day before the operation. This relieves the load on the heart and improves the prognosis for heart surgery.

The clinic offers modern artificial and biological heart valves for valve replacement surgery. These include mechanical bileaflet prosthetic heart valves of internationally renowned makes. In addition, bio-prosthetic heart valves are also available for implantation particularly in older or patients or patients with a contra-indication to Marcumar therapy. Special attention is given here to so-called "stentless" bio-prosthetic heart valves where the valve leaflet is not fitted on a stent as in conventional bio-prosthetic heart valves. These prosthetic heart valves offer enhanced haemodynamic properties and probably a longer service life.

Preserving the patient's own heart valves

If at all possible, today surgeons also try to preserve the patient's own heart valves, referring in particular to the mitral and tricuspid valve, under certain conditions. In our opinion, preserving the patient's own valves is always preferential to valve replacement. Echo cardiogram controls are possible during the operation to check on the reconstruction results.

Frequently, mitral disease (and other forms of heart disease needing surgery) is associated with atrial fibrillation. This usually requires Marcumar therapy with extensive side effects. In recent years, effective surgical procedures have been developed for treating such symptoms. The chances of success for such surgery is very promising, and corresponding procedures are possible in Nuremberg. In this case, the post-operative care of the patient is shared in close cooperation with the cardiac electrophysiologists working in our hospital.

The surgical spectrum of the heart clinic also includes surgical procedures to the ascending aorta and the aortic arch, together with scheduled surgery for aneurysms with and without affected aortic valve, and emergency surgery for dissected aorta with threatening rupture.

Cardiac insufficiency clinic

Some patients suffer from a pronounced deterioration of the heart rate in the course of heart disease, but are not candidates for conventional heart surgery for various different reasons. These patients can find on-going support through the close cooperation with the heart surgery department at Erlangen University Clinic in the so-called cardiac insufficiency clinic . Here it is possible to try out the full range of conservative therapy on the one hand, and also to evaluate selective surgical possibilities such as the implantation of a ventricular assist device or heart transplants.

Doctors

Operations in the heart surgery centre in Nuremberg are performed by specialised heart surgeons who have been trained and qualified according to the guidelines of the German Society for Thorax, Heart and Vascular Surgery, guaranteeing a high standard of quality. Regular, active attendance at specialist medical congresses on a world-wide scale are a prerequisite to guarantee further on-going training of the employed staff.

After surgery

After the operation, the patients are looked after on the surgical intensive care unit run by the Department for Anaesthesia and Intensive Medicine and then returned to the normal heart surgery ward until ready to be discharged. Here continuous central monitoring is possible, which contributes to patient safety. During this time, the patients are nursed and mobilised by specially trained staff. This is usually followed by a period of convalescence supported by the affected health insurance company, with the corresponding arrangements being made while the patient is still on the heart surgery ward to avoid any unnecessary delays to the patient's recovery.