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Coronary heart disease (ischemic heart disease) is a condition caused by insufficient blood supply to some areas of the heart muscle. The cause is a disease of the coronary arteries (usually atherosclerosis - arteriosclerosis). The working heart muscle suffers from oxygen deficiency. The condition results in cardiac pain and lowering of cardiac output with a whole series of consequences for the whole organism. An acute form of ischemic heart disease is z. B. acute myocardial infarction. The chronic forms include conditions following myocardial infarction, angina pectoris, various disorders of the cardiac conduction system and cardiac arrhythmias.
The dangerous thing about CHD is that, even without symptoms, there may already be a high degree of atherosclerosis and constriction of the coronary arteries. Only a restriction of the vessel lumen by at least 60% leads to a demonstrable reduction of blood flow.
The most common cause of CHD is atherosclerosis (arteriosclerosis) of large coronary arteries and microangiopathy (narrowing of small coronary artery branches).
In atherosclerosis, deposits of cholesterol, fatty acids and lime on the walls of the vessel lead to the formation of so-called atherosclerotic plaques. These constrict the blood vessel and impede blood flow, so that the supply area can no longer be sufficiently supplied with oxygen and nutrients.
Microangiopathy is a form of atherosclerosis that affects the small blood vessels from the arterioles to the capillaries. Often affected by microangiopathy are diabetics.
Ischemic artery heart disease is a disorder caused by decreased blood supply to the heart. Due to narrowed arteries, the heart muscle doesn’t get enough blood and oxygen. It can provoke a myocardial infarction, angina and arrhythmia, which in some cases leads to death. Nowadays there are several medical procedures for control and treatment of cardiac ischemia, for example, drug therapy, but also a surgical operation.
The MediClin centre Lahr/Baden implements several procedures for diagnosis and treatment of cardiovascular diseases. It specializes in thoracic, cardiovascular surgery. Professor and Doctor of medicine Eberhardt von Hodenberg is physician-in-chief of MediClin and also a specialist in cardiology and angiology. The modern centre performs more than 2000 surgeries and treats about 5000 patients a year. Many of them suffer from ischemic disease. MediClin in Germany is one of the most qualified and modern specialized clinics in Europe.
Implantation of aortocoronary shunts (revascularisation)
Aortocoronary shunting is a surgical intervention that uses shunts to connect blood vessels with the aorta. Mostly this treatment procedure is used in patients with ischemic disease associated with serious stenosis (blocked arteries). It should help to bypass a circulatory blockage of the muscle.
Shunts implantation is an open surgery. During the operation physicians use a heart-lung machine because the organ still beats and is full of blood.
Afterwards 70 percent of patients with ischemic disease don’t have any symptoms.
Implantation of cardiac shunts without heart-lung machine (ORCAB)
During ORCAB no heart-lung machine is needed, due to the use of a special machine that stabilizes the fluctuation.
Since 2005 MediClins surgeons use ORCAB for the treatment of patients with coronary artery disease that leads to renal, lung disorders or even myocardial infarction.
This method has no side effects, doesn’t cause internal bleedings, stroke and any other dysfunctions.
Blocked coronary arteries may occur in patients with ischemic disease. Coronary angioplasty is a treatment procedure that opens narrowed arteries with a special balloon to improve the blood flow to the heart muscle.
During angioplasty a surgeon makes a tiny incision in the groin, arm or wrist of the patient and inserts a catheter in form of a thin tube into a vessel. A small balloon is inserted through the artery and immediately expands it by squashing fatty deposits against the artery wall. This procedure helps to improves the blood flow.
Other treatment of coronary artery disease is the implantation of stents. These are short wire-mesh tubes also inserted into the artery, which stay there. Both of the surgical interventions are minimal invasive and less painful.
Transmyocardial Laser Revascularization (TMLR)
In 10-15 percent of patients coronary artery disease is characterized by narrowed coronary arteries, which reduces supply of oxygen-rich blood to the heart muscle.
TMLR is a very unique method to treat patients with ischemic pathology and serious stenosis.
It is an innovative surgical operation that uses laser to increase the flow of blood into the left ventricle and lower the thoracic pain caused by ischemic disease and angina. The laser makes tiny channels through the heart, which help to supply oxygen-rich blood to the muscle. The patient gets a minimal invasive incision. The heart doesn’t stop working during the surgery. New arteries increase the function of the organ due to supply of a higher amount of blood to the heart.