ENDOPROSTHETICSORTHOPAEDICS / CARDIOLOGY ASKLEPIOS NEWSLETTER Issue 2/2017 Photo: Fotolia Fabio Balbi Dear Readers, Clinic operator Asklepios The heart is a very special organ and much hospitals. Some hospitals far exceed even Asklepios is one of the largest operators of more than a hollow muscle that pumps this level and are among the best in Europe private clinics and healthcare facilities in blood through the body. and in some cases the world. Here we help Germany. Founded more than 30 years ago, to develop and research new techniques the chain of clinics follows a responsible In Germany and numerous other countries which later all hospitals can benefi t from. and sustainable strategy geared towards a and cultures, the heart is closely associated high level of safety and quality. The group with feelings. This is not wholly wrong as In this newsletter, we present three of these currently has more than 150 healthcare it reacts very sensitively to stimuli to the hospitals with exceptional cardiology units. facilities spread across Germany between autonomic nervous system. the Island of Sylt on the North Sea and Wishing you the best of health! Lindau by Lake Constance and employs Heart disease can take an acute and very more than 46,000 staff. In the 2015 fi scal dramatic course, but it can also begin in a Faithfully, year, Asklepios treated around 2.3 million gradual fashion. At Asklepios, the patients. treatment of heart disease has been one the core skills of our hospitals for many Medical quality management at the years. Cardiac treatment of the highest Dr Thomas Wolfram, highest level is an area in which Asklepios standard is kept at the ready in all our Chairman of Asklepios Kliniken GmbH particularly excels. The clinic operators benefi t from the group’s structure to promote knowledge transfer between the facilities and to provide particularly excellent treatment. The results are also published regularly. For instance, the Medical Findings Report is published annually at www.qualitätskliniken.de of which Asklepios is a charter member. Moreover, 25 criteria on patient safety are published regularly on the Internet. Photo: Fotolia peshkova Page 1 of 65 ASKLEPIOS NEWSLETTER Issue 2/2017 CARDIOLOGY Treating heart failure in good time — in the Asklepios Clinic in Harburg Cardiac insufficiency or heart failure is one of the most frequent causes of death in industrial countries. More than 20 million people around the world suffer from this serious illness which is characterised by the heart's inability to pump sufficient blood. As a result, the body is not supplied with enough oxygen, and patients complain increasingly of fatigue, shortness of breath, dizzy spells, constant coughing, swollen ankles and legs as well as water reten- tion around the abdomen. Heart failure is usually caused by a different heart disease: In the case of a heart attack, inflammation of the heart muscle, coronary heart disease or hardening of the arteries, heart muscle tissue is destroyed and replaced by scar- ring with the result that the muscle can Photo: Fotolia psdesign1 no longer pump properly. Doctors speak of insufficiency at stages NYHA III and NYHA and her team attach great importance to systolic heart failure. Diastolic heart failure, IV are treated here every year by a team of detecting structural heart disease as early on the other hand, is often caused by high experienced cardiologists under the lead- as possible and giving the appropriate blood pressure or damaged blood vessels ership of Chief Physician Dr. Britta Gold- therapy before the heart grows even weaker. due to diabetes: The heart muscle tenses mann. Cardiologists, heart surgeons, lung Because the earlier this occurs, the more and is no longer able to relax. However, and kidney specialists, vascular surgeons doctors can do for their patients. both forms of heart failure lead to the same and many other specialist departments symptoms: shortness of breath on exertion. work hand in hand here to cover all aspects Contact of heart failure and to offer the latest Dr. Britta Goldmann Anyone suffering from heart failure needs treatment methods — from elaborate drug Chief Physician at the Department of to receive the right treatment as quickly therapies administered under supervision Cardiology as possible as this can extend life expec- in intensive care, via special pacemakers Tel.: 040 181886-2830 tancy by around ten years. In every fourth (CRT, ICD, CCM) to the correction of heart Fax: 040 181886-3427 case, the heart even recovers completely if valve defects by catheter (MitraClip, TAVI) [email protected] treated quickly, whilst it is unable to regain or heart operations performed in the hybrid its old strength if the disease is already operating theatre. There is also a high- Asklepios Klinikum Harburg advanced. The severity of heart failure tech support system, the Impella® pump Eißendorfer Pferdeweg 52 is divided into four stages in accordance available for the temporary treatment of 21075 Hamburg with the guidelines issued by the New York acute heart failure. This complete range of www.asklepios.com/hamburg/harburg/ Heart Association (NYHA), based on the equipment coupled with the experience of experten/kardiologie complaints experienced: NYHA I (initial our renowned experts have resulted in more heart failure with no symptoms) to NYHA IV and more patients with heart insufficiency (difficulties even when resting). being sent to Hamburg-Harburg to be cared for, even from distant hospitals. The diagnosis and treatment of heart failure is one of the main areas which the Askle- Even if most patients treated for heart pios Clinic in Harburg, Hamburg focuses insufficiency in the Asklepios Clinic in Har- on. More than 2,000 patients with heart burg are already seriously ill, Dr. Goldmann Page 2 of 5 ASKLEPIOS NEWSLETTER Issue 2/2017 CARDIOLOGY / HEART SURGERY Repairing defective heart valves by means of a catheter It was only a few years ago that anyone suffering from a constricted or leaky heart valve would sooner or later have to face up to a major heart operation. But an opera- tion of this nature involving the use of a heart-lung machine is much too stressful and dangerous for many older or seriously ill patients. In many cases, defective heart valves can now be repaired or even re- placed inside a beating heart — in a gentle procedure using a catheter. Defective aortic valves, above all, are being more and more frequently replaced by high-tech pros- theses introduced by catheter in the groin in a folded state and deployed and anchored Photo: Fotolia Monkey Business at their implantation site (TAVI procedure). anatomies can vary significantly. The progress the so-called "Heart Team", and the various Leaky mitral valves are treated by means made in valve technologies and the growing treatment options are explained to them. of various catheter procedures: Either the experience amassed by the doctors have The Heart Team consists of cardiologists, tips of the two valve leaflets are joined with steadily expanded the areas of application heart surgeons and cardio-anaesthetists who a clip (MitraClip), or a ring is fitted around for minimally invasive procedures in the last perform the TAVI procedures together in the enlarged mitral valve to make the open- few years. While catheter-based procedures two special hybrid operating theatres in the ing smaller. were initially reserved for high-risk patients clinic. It is crucial for the patient's safety, for whom open-heart surgery would be particularly with these modern techniques, Specialists at the Cardiovascular Centre in too dangerous due to their age or poor that the cardiologists are supported by an the Asklepios Clinic in St. Georg, Hamburg, condition, these gentle procedures have experienced heart surgery department such are among the pioneers of these techniques, now also proven themselves for younger as that run by Prof. Dr. Michael Schmoeckel and they participate in numerous interna- patients without any serious associated at the St. Georg Asklepios Clinic, which is tional studies intended to refine them. The illnesses. In one of the first centres in the ready to spring into action in the event of heart valve programme using the MitraClip world, the heart specialists at the St. Georg complications. was launched here in the Cardiology De- Asklepios Clinic are now also tackling the partment under the leadership of Prof. Dr. catheter-based repair of the tricuspid valve Contact Karl-Heinz Kuck in 2008, and a short time for which there were previously no gentle, Dr. med. Christian Frerker later techniques for treating defective aorta catheter-based treatment options whatever. Head of Interventional Valve Therapy, valves were added. The experts making This heart valve with three flaps directs the Valve Consultations up this interdisciplinary team under the blood from the right atrium into the right Tel.: 040 181885-2033 leadership of Senior Physician Dr. Christian ventricle and is often leaky in patients with Fax: 040 181885-3869 Frerker can now look back on more than heart failure. The result is that patients [email protected] 1,800 TAVI and more than 800 MitraClip suffer from an accumulation of fluid in their procedures. In 2015, the clinic was one legs and abdomen and shortness of breath. Asklepios Klinik St. Georg of the first TAVI centres to be certified by Lohmühlenstraße 5 the German Cardiac Society. Besides their Close collaboration between cardiologists 20099 Hamburg vast experience, the heart specialists in the and heart surgeons is becoming more www.asklepios.com/hamburg/ clinic have an extensive arsenal of different and more important to ensure that each sankt-georg/experten/kardiologie/ types of prostheses at their disposal with patient is treated using the best possible herzklappenerkrankungen the result that they can select a perfect techniques for them personally.