Coronary artery bypass surgery
Despite all the advancements in interventional catheter therapy, cardiac surgical therapy of coronary heart disease (CHD) still offers proven qualitative advantages, especially in stable CHD, which is clearly reflected in the current joint guidelines from the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS).
The options of conventional valve surgery now extend from valve replacement with established mechanical solutions as well as the significantly increasing use of biological valve prosthetics, through to complex reconstructive surgical techniques. Especially the conservative procedures on the mitral and aorta valves can have a very positive effect on the life quality of these patients operated. These complex techniques are often time-consuming and therefore benefit not least from advancements in modern perfusion technology.
Congenital heart defects
Modern perfusion technology allows specialised cardiac surgeons to correct even complex congenital heart defects in procedures that are usually just as complex or at least allows them to offer palliative solutions with multi-stage approaches, as necessary. Consequently, the number of adults with corrected congenital heart defects requiring specialised medical support, usually lifelong, is on the increase.
Thoracic vascular surgery
Thoracic vascular surgery encompasses both elective surgical treatment of aortic aneurysms and treatment of aortic dissections, whereby, in the majority of cases, the latter usually represents an acute, life-threatening situation. Therapy usually involves prosthetic replacement of the vascular region affected, whereby endovascular procedures are increasingly deployed on their own or in combination with conventional surgical procedures.
Today the transplantation of a donor heart is still a severe surgical intervention which is also accompanied by emotional and ethical aspects to a considerable extent. However, the biggest challenge is still the insufficient number of donor organs available – a situation conducive to the increased use of ventricular assist systems in the future.