Cardiac medicine: Frequently asked patient questions

Catheter-assisted interventions on defective heart valves are becoming increasingly important. According to current figures, such procedures are used in almost 50 percent of cases, particularly in the case of functional disorders of the aortic valve, such as a narrowing (stenosis) or, more rarely, leakage (insufficiency). A minimally invasive procedure is also available today for the treatment of mitral valve regurgitation.

The so-called MitraClip™ holds the valve leaflets together like a clip and thus reduces leakage. Even partially congenital defects of the pulmonary valve are increasingly being treated with catheter-based methods nowadays. Repairing the tricuspid valve in this way still poses some difficulties for experts, but the first experimental approaches are also being tested here.

Three treatment options are available to repair or replace a defective heart valve. In classic valve replacement, the diseased heart valve is surgically removed and replaced with a biological or mechanical prosthesis. In some cases, a repair can also be carried out by the surgeon, in which the valve function is restored using special surgical techniques. These methods are mainly used in mitral and tricuspid valve surgery and can sometimes be minimally invasive.

Nowadays, however, there is also the option of interventional, i.e. targeted and therefore tissue-sparing treatment. These include, for example, mitral valve repair using the MitraClip™ or TAVI, short for transcatheter aortic valve implantation, in which the new heart valve is placed minimally invasively in the heart through a groin catheter or via the apex of the heart.

In most cases, the term artificial heart refers to so-called artificial heart support systems. They are mainly used when heart failure can no longer be treated with medication. Experts refer to these pump systems as VADs (ventricular assist devices). Depending on which ventricle they are placed in, experts differentiate between left ventricular assist devices (LVAD) and right ventricular assist devices (RVAD).

When looking for a cardiologist, it is advisable to consult your own family doctor first. They often look after their patients over a longer period of time and have an appropriate network of specialists in the area. There is also the possibility of joining self-help groups in the region to exchange information with other sufferers. Specialized heart centers can also provide valuable tips. You can also use our website, for example, to find specialists in your area.

For the first four weeks after the procedure, patients should take it easy and avoid strenuous activities so that the wound can heal completely. After that, a check-up should be carried out every three months. Later, these check-ups take place around once a year, depending on the individual's state of health. If patients receive a biological valve replacement, for example, they then take anticoagulant medication for three months to ensure smooth blood flow. With a mechanical valve, however, this medication must be taken for the rest of the patient's life.

If heart valve patients subsequently undergo further procedures, such as dental surgery, it is advisable to take antibiotics as a preventative measure to prevent bacterial infections of the heart valves.

The aortic valve between the left ventricle and the aorta consists of three leaflets. In some cases, age-related signs of wear and tear lead to calcification of the leaflets, causing the opening area of the valve to narrow. As a result, the heart has to pump harder to supply the body with sufficient blood. In the long term, however, this increased effort leads to a pathological enlargement of the muscle, so that its pumping capacity decreases over time.

As aortic valve stenosis cannot be treated with medication and therefore progresses continuously, those affected should be closely monitored by their doctor and operated on at an appropriate time.

Probes are always used when cardiac surgeons implant an electrode in or on the heart. This is the case with pacemakers, for example, which permanently support the pumping function and emit electrical impulses if the heart beats too slowly or irregularly. They are usually placed in the subcutaneous fatty tissue or under the pectoral muscle on the collarbone and are connected to the probe on the heart via very fine wires, so-called electrodes.

Apical hypokinesia describes the reduced mobility of the apex of the heart compared to the rest of the muscle and occurs after a heart attack, for example. As a result, less blood enters the body's circulation and patients often suffer from shortness of breath or rapid exhaustion. In most cases, this condition can be detected during an echocardiogram so that doctors can initiate individualized treatment.

Whether a pacemaker is a suitable method of treating heart failure depends on the cause of the reduced pumping function. If this is due to a cardiac arrhythmia, for example, there is a possibility that a pacemaker will provide relief.

In any case, a thorough examination by a cardiologist is recommended to diagnose the cause of the disease.

The MitraClip™ is currently the most frequently used procedure for interventional repair of the mitral valve. Over 25,000 patients worldwide have now been treated with this method. Various studies show that heart failure is noticeably reduced in many patients after the procedure and that they are more resilient.

It is also possible to treat patients with a special ring, the so-called Cardioband, which reduces the size of the mitral valve ring and thus stabilizes the leaflets. However, due to its novelty, there is little clinical experience with this method to date.

If there is insufficiency of the mitral valve, the artificial mitral ring is considered the standard treatment and has a good surgical prognosis. Around 90 percent of defective heart valves can be repaired using this method, in which the defective valve leaflets are stabilized after surgical reconstruction. The remaining ten percent are often patients in whom the mitral valve cannot be repaired and is therefore completely replaced.

The MitraClip™ is a possible treatment option for patients who cannot be operated on or only with a greatly increased risk.

No concrete statement can be made about this, as there is no scientific link between tinnitus and heart disease. Nevertheless, patients repeatedly report such abnormalities, which can possibly be attributed to the fact that heart surgery is an incisive experience that is subconsciously associated with other events.

If patients have already had a heart valve replacement and need to undergo further surgery, for example due to calcification or degeneration of the valve, minimally invasive procedures using a catheter are often used. However, individual treatment always depends on various factors such as the patient's age or general condition, although minimally invasive procedures are being used more and more frequently.

Patients suffering from hypertrophic obstructive cardiomyopathy often show symptoms such as cardiac arrhythmia, shortness of breath or dizziness. As thickening of the heart muscle is a very complex disease, all possible measures should be discussed in detail with the relevant doctor. These range, for example, from drug therapy to targeted sclerotherapy of the thickened tissue as part of a transcoronary ablation of septal hypertrophy, or TASH for short, to surgical correction. What happens after treatment also depends on the patient's individual condition and the chosen form of therapy.

The costs for the treatment of mitral valve regurgitation using a MitraClip™are generally covered by the respective insurance provider in Germany. There are no extra costs that would have to be borne by the patient.

Statutory health insurance

The treatment must be carried out in a hospital that meets the quality criteria of the Federal Joint Committee (G-BA). The Federal Joint Committee (G-BA) is the highest decision-making body of the joint self-administration in Germany.
To find a doctor and/or clinic in your area that meets these quality requirements, visit the clinic search.

Private health insurance

Please contact your private insurer for more information on possible requirements for doctor and clinic searches.