Treatment of Heart Defects, However Complex
In the Department for Congenital Heart Disease – Pediatric Cardiology, our highly specialized team has been treating patients of all ages with congenital heart defects for more than 25 years. In addition to standardized surgical and interventional correction we offer individual treatment solutions for patients with highly complex heart defects.
Our Department has a specialized intensive care unit, an intermediate monitoring ward, outpatient facilities and a Competence Center for Adults with congenital heart defects.
Range of Services
Competence Center for Adults with Congenital Heart Defects
Since 2011 our Department has been certified as a supraregional center for the treatment of GUCH (grown-ups with congenital heart defects). In Germany there are currently only three such supraregional GUCH centers.
Our patients profit from up-to-the-minute diagnostic imaging procedures. These include special ultrasound examinations (three-dimensional, tissue Doppler), heart catheterization, cardiac magnetic resonance imaging (MRI) and cardiac computed tomography (CT).
Cardiac magnetic resonance imaging is an established procedure for diagnosing congenital heart defects, identifying the type of heart defect and studying the precise function of the individual heart.
We have two so-called hybrid operation rooms. These are equipped with a heart-lung machine and modern catheterization laboratory facilities, so that surgical and heart catheter techniques can be combined. The advantage is that these combined procedures are shorter and less complex than other operations and thus the risk and the strain for the patient are reduced.
Heart Catheterization and Interventional Treatment
Twenty years ago heart catheterization was used as a purely diagnostic tool but today it has been refined and can also be used for treatment procedures. Simple, non-complex heart failures may be treated in this manner, without an operation. Patients with complex heart defects are also prepared by heart catheterization for their operation or undergo postoperative catheterization procedures.
- Dilation of narrow heart valves by catheterization technique
- Opening of closed heart valves by the application of high frequency electric current
- Closure of defects of the atrial and ventricular septum (dividing wall) by placement of an implant (occluder) by catheterization. We use all the commercially available occluders
- Use of heart valves for the non-surgical treatment of incompetence and narrowing of the valve to the pulmonary artery (pulmonary valve)
- Closure of defects of the atrial septal defects without exposure to X-rays
- Treatment of narrowing of vessels close to the heart in newborns and children by placement of a special vessel support (growth stent), which adapts as the patient grows
- Treatment of severe narrowing of the aorta (main artery) with coated vessel prostheses
- Pacemaker treatment to optimize the heart function in patients with heart failure in childhood (synchronization therapy with triple-chamber pacemakers)
- State-of-the-art treatment procedures for severe heart rhythm disturbances by the implantation of defibrillators (AICD) and pacemakers for single, double and triple chamber stimulation
- Implantation of minimally invasive defibrillator systems (S-ICD; Cameron Health), which no longer require leads to be placed in the heart or vessels. Patients with AICDs and particularly complex heart defects or Eisenmenger syndrome can profit from this technology
- Removal of pacemaker leads with the most modern instruments, such as mechanical extraction aids
- Treatment of patients with high lung pressure (pulmonary arterial hypertension) in children and adults
- Implantation of drug pumps for the continuous infusion of treprostinil as an alternative treatment for pulmonary arterial hypertension
- Perioperative monitoring of cerebral perfusion by non-invasive procedures
- Non-invasive cardiocirculatory monitoring by electrical velocimetry for continuous measurement of cardiac output
Origin of patients
Care is provided primarily for patients from Berlin and Brandenburg (717 in the year 2015). A further focus is on the eastern German federal states but more and more patients come from all over Germany.
The number of inpatients treated at our hospital in the past seven years has increased slightly but steadily. Many of them are newborns, on the one hand, and adults with congenital heart disease, on the other.
Diagnostic and therapeutic procedures are increasingly being moved to the outpatient sector. This clear trend in the German health care system means that the demands made on outpatient care are steadily increasing.
Age Distribution of Patients (1990 – 2015)
Twenty to twenty-five percent of adult patients are treated as inpatients with an operation or intervention. Over fifty percent of adult patients are treated as outpatients.
Operations and Catheter Interventions
The number of patients treated by surgery or heart catheterization this year was again higher than ever before (1,125 patients).
The DHZB is an international referral center and certified superregional center for the treatment of GUCH (grown-ups with congenital heart defects).
The number of patients operated upon has risen steadily since the year 2000. At 666 the number is clearly higher than in past years.
Heart Catheter Examinations
The DHZB specializes in minimally invasive heart catheterizations. The number has risen to 622.
Mortality After Operations for Congenital Heart Defects
The mortality rate for operations for congenital heart defects is 2.2 percent, putting it at a low, stable level in international comparison. This low rate is due to the specific DHZB treatment guidelines we have developed and our unified treatment strategies.
In patients with congenital heart defects the need for valve operations is particularly common. The preferred form of treatment is to preserve the patient’s own heart valve by reconstructive procedures.