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Department of Cardiovascular Surgery by murplelake76

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									Department of Cardiovascular Surgery

The Clinic for Cardiovascular Surgery      At the Clinic for Cardiovascular Surgery   At the German Heart Centre Munich all
at the German Heart Centre Munich is       the complete spectrum of cardiac sur-      valve-preserving techniques are perfor-
a specialised clinic for the treatment     gery is performed, i.e. paediatric sur-    med, especially with regard to the mitral
of congenital and acquired cardiac         gery, reconstruction and replacement       valve. Furthermore, the clinic is equip-
defects.                                   of heart valves, bypass surgery, surgi-    ped with a telemanipulator (robot) for
                                           cal reconstruction of the intrathoracic    special operations. The world's first total
                                           aorta, heart transplantation and im-       endoscopic mitral valve reconstruction,
                                           plantation of artificial hearts.           a procedure which did not require ope-
                                                                                      ning of the thorax, was performed at
In the field of acquired heart defects, more and more procedures are performed        the German Heart Centre Munich with
in a minimally invasive fashion. For instance, the mitral valve is reconstructed      such a telemanipulator in 2000. Certain
through minimal incisions on the right side of the thorax. For surgery on the as-     procedures on the coronary vessels can
cending aorta, the sternum no longer has to be opened completely, but the ope-        also be performed in a total endoscopic
ration can be performed through a partial opening of the upper part of the ster-      fashion with the telemanipulator. Some
num (partial sternotomy). Thanks to state-of-the-art surgical techniques, defective   operations on the coronary vessels can
heart valves can now be reconstructed instead of being replaced in an increa-         now be performed on the beating heart
sing number of cases.                                                                 without the use of the heart-lung-ma-
                                                                                      chine, which marks another major ad-
                                                                                      vancement in cardiac surgery.




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                                                                                     Contributions to cardiac surgery:

                                                                                     @ First successful heart transplantation
                                                                                       in Germany
                                                                                     @ Introduction of anastomosis of the
                                                                                       mammary artery in Germany
                                                                                     @ New methods of conserving heart
                                                                                       transplants
                                                                                     @ Establishment of a homograft bank
                                                                                       for the preparation of human valves
                                                                                     @ Use of biological valve prostheses
                                                                                     @ Improvements in extracorporeal
                                                                                       circulation
                                                                                     @ Quality assurance in cardiac surgery
                                                                                       (pilot project)
                                                                                     @ Surgery with telemanipulators
                                                                                     @ Development of a new centrifugal
                                                                                       pump

                                                                                     International leading position in the
                                                                                     correction of complex congenital
                                                                                     heart defects:

                                                                                     @ Anatomical correction of TGA (trans-
                                                                                       position of the great arteries)
                                                                                     @ Fontan's operation
                                                                                     @ Operation of BWG syndrome (Bland-
Various procedures are available at         lung-machine. Minimally invasive           White-Garland syndrome)
the Clinic for Cardiovascular Surgery to    procedures also play a more and more     @ Vavuloplasty in patients with
treat defects of the intrathoracic aorta.   important role in paediatric cardiac       Ebstein's anomaly
Among other things, stents (internal        surgery. The German Heart Centre has     @ Diaphragmatic pacemaker in patients
vascular support devices) have been         its own valve bank, where human valves     with Ondine's syndrome
implanted for several years without         are prepared for the replacement of      @ Double switch operation
opening the sternum and without             the pulmonary valve, a frequent proce-
using the heart-lung-machine.               dure in children with congenital heart
                                            defects.
The Clinic for Cardiovascular Surgery is
among the world's leading institutions      The Clinic for Cardiovascular Surgery
in the treatment of congenital heart        has a large experimental laboratory
defects in newborns, infants and chil-      where numerous research projects ta-
dren. Complex congenital heart defects      ke place, e.g. the development of an     techniques for surgical robots as well
can even be corrected in very small         automatic heart-lung-machine, the        as the development of an artificial
babies with a birth weight of less than     breeding of tissue cells (tissue         heart-replacement pump. In this field,
2000 grammes. This is possible by           engineering), the experimental and       scientists work hand in hand with
means of deep hypothermia of the            clinical examination of heart valves,    physicians, which guarantees an extra-
organism with the aid of the heart-         the development of state-of-the-art      ordinary degree of scientific efficiency.




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   Prof. Dr. Rüdiger Lange
   Director of the Department of Cardiovascular Surgery


Interview                                     after the operation. This is a chance to    year, about two per day. On the day
                                              transform stress into energy.               before an operation, I cannot do stre-
                                                                                          nuous sports because I need 100% of
   Even as a student you were determi-        Are there times when you regret             my energy for the operation the next
   ned to be a heart surgeon. Why?            having chosen this profession?              day. I cannot eat too much either be-
   Surgery on the heart is more complex       No. Naturally, sometimes I would like       cause then I sleep restlessly.
   than on motionless organs. But as a        to go out to eat or for a walk in the
   student I did not know that a heart        park. Just like that. There are too many    How long does a heart operation take?
   surgeon is exposed to much more            days on which I get up in the morning       For open-heart operations the heart
   stress than any other surgeon.             and go to the clinic when it is dark out-   has to be stopped. This must not take
                                              side and when I come home, it is dark       longer than three hours.
   Stress leads to heart attacks, at least    again. But then there are the moments
   some doctors say...                        of thankfulness that I can help so many     Can you interrupt such an operation?
   Yes, OK. But I think that stress at work   people.                                     No.
   or stress induced by problems is not a
   cause of heart disease. What is more       Those who want to help must suffer?         With the need for such high concen-
   important is how the individual deals      The little free time I do have, actually    tration, do you sometimes have
   with stress. My work is very rewarding,    has to be coordinated with my work. I       doubts about yourself?
   especially the graditude of the patients   perform about 450 operations each           No, if a race driver thinks he should




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drive more slowly, he is not very well     are above all afraid when they come to        Will genetic engineering and biotech-
suited for his job.                        such a highly specialised clinic. The         nology change heart surgery?
                                           first thing we do is try to alleviate their   Both fields will certainly cause major
Dr. Brinkman from the Black Forest         fear and create an atmosphere of trust.       changes in surgery. In the years to come
Clinic (a long-running German televi- Not only a relationship of trust with              there will be fewer operations because
sion series) constantly had self doubts. the nursing staff and the physicians,           we will learn how to prevent diseases.
Heart surgeons are subjected to much but also trust in the healing power of
more pressure than the doctors on tele- modern medicine, which is our most               For many people the heart is not a
vision. In the programme, the doctors      effective tool.                               normal organ but the site of the soul,
are mainly concerned with the personal                                                   emotions and feelings. What is the
problems and the everyday life of their There are several heart centres in               heart for you?
patients. If I were to do that, I would be Germany. Is there competition for             The emotional component is based on
in need of a psychiatrist in a few months. patients?                                     human imagination, not reality. Still, as
I get a stomach-ache when I watch those Yes, that is why additional specialisa-          a physician I feel respect for the heart.
programmes. But I know some collea-        tion like here at the German Heart            It has a central position in the body.
gues who enjoy them.                       Centre is becoming more and more              People feel that it is an organ that has
                                           important. The best possible care for         a life of its own. But of course that is
Do you and your colleagues at least        and the wellbeing of our patients de-         nonsense. We only live because the
have enough time to deal with the          termine our thoughts and deeds. That          heart supports the circulation.
psychological state of the patients?       is why many of our patients recom-
Of course. Patients with a heart problem mend our clinic to others.




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