ENPaediatric cardiology in Germany diagnoses and treats children with heart conditions, mainly congenital heart defects, in specialised centres: heart ultrasound, catheter procedures, surgery and follow-up into adulthood. Parents usually arrive here after a remark during a pregnancy scan, after a murmur was heard in their child’s chest, or when surgery was proposed at home and nobody explained it properly. Congenital heart defects can be treated today in almost every case. But treatment is not one procedure — it is a plan spanning years, and where the first step is taken matters.
Below: how a child with a heart defect is examined in Germany, what a catheter can do without opening the chest, when surgery is needed, who looks after the child between procedures and what happens once the child grows up. More on children’s medicine: treatment of children in Germany.
Where it starts: the examination
The examination starts with echocardiography, a heart ultrasound and the paediatric cardiologist’s main tool: painless, radiation-free and, in experienced hands, able to answer most questions (see echocardiography in Germany). Foetal echocardiography during pregnancy is a separate case: if a defect is found before birth and the baby will need help at once, delivery is planned at a hospital with paediatric heart surgery.
If ultrasound is not enough, cardiac MRI, computed tomography or 24-hour rhythm monitoring follow. In complex defects, cardiac catheterisation measures the pressure in the lung vessels, because those numbers decide whether an operation is possible at all.
So the documents travel first and the child second: reports, ultrasound recordings and previous operation notes are read before arrival and often show whether a new examination is needed or the case is already a planned procedure.
What is done through a catheter
Through a catheter, doctors close holes, widen narrowings and place stents without opening the breastbone. The thin tube reaches the heart through a vessel in the leg; there it closes a hole in the septum with a device, widens a narrowed valve or vessel with a balloon, or places a stent, a mesh tube that keeps a vessel open. The child usually goes home sooner than after surgery. But not every defect can be treated this way: a team of paediatric cardiologists and heart surgeons decides, not the parents’ wish.
This is done, for example, at the department for congenital heart defects and paediatric cardiology of the German Heart Centre in Munich, headed by Professor Peter Ewert, whose stated fields are interventional paediatric cardiology, catheter closure of atrial septal defects and care of adults with congenital heart disease. In Bad Oeynhausen, Professor Stephan Schubert heads the department of paediatric cardiology and congenital heart defects at the Heart and Diabetes Centre NRW.
When surgery is needed
Surgery is needed when a catheter cannot repair the defect: some defects can only be corrected on the open heart. Modern paediatric heart surgery operates even on newborns weighing a few kilograms, which takes a team of its own: surgeon, paediatric anaesthetist, a perfusionist running the heart-lung machine, and paediatric intensive care.
At the German Heart Centre in Munich, Professor Jürgen Hörer heads the department for surgery of congenital heart defects and paediatric cardiac surgery; his stated fields are surgery of congenital heart defects in children and adults, risk scores for the complexity and expected mortality of such operations, and quality of life in adults with congenital heart disease. In Bad Oeynhausen, Professor Eugen Sandica heads the department of paediatric cardiac surgery and congenital heart defects.
Complex defects are often treated with a series of procedures months or years apart rather than one operation; tetralogy of Fallot is an example (see surgery for tetralogy of Fallot in Germany). We say this plainly so that parents plan a route, not a trip, and the doctor at home knows what comes next.
Life between procedures, and growing up
After discharge, a paediatric cardiologist follows the child: sets activity limits and reviews them as treatment goes on, plans vaccinations around operations and decides whether prevention of infective endocarditis is needed before dental work. Under the guideline of the German Society for Paediatric Cardiology (DGPK), children at high risk get an antibiotic before dental procedures. A German discharge letter naming the exact devices and drugs is what a doctor at home will work from.
Adults are seen by cardiologists trained in EMAH, Erwachsene mit angeborenen Herzfehlern: adults with congenital heart defects. In Germany this is a separate qualification, because a grown child with a repaired heart does not become an ordinary adult patient. The transfer from paediatric to adult cardiology is planned in advance, from the teenage years (see heart treatment in Germany). In Berlin, computer modelling of the heart and vessels is the work of the institute headed by Professor Titus Kühne at the German Heart Centre of the Charité.
Frequently asked questions
Can a heart defect be treated without opening the chest?
Sometimes. Through a catheter, doctors close some holes in the septum, widen narrowed valves and vessels, and place stents. Whether this suits a child depends on the defect and the heart’s anatomy; paediatric cardiologists and heart surgeons decide together after the examination. Otherwise, surgery is proposed.
How young can a child be for a heart operation?
Age alone is no barrier: paediatric heart surgery operates even on newborns. The defect sets the timing: some are repaired in the first days or weeks of life, others once the child has grown, complex ones in stages. The cardiologist and surgeon choose the moment and explain why.
What if a heart defect is found during pregnancy?
First, a detailed foetal echocardiography by a prenatal specialist and a paediatric cardiologist clarifies the defect and the help the baby will need. If help is needed at once, delivery is planned at a hospital with paediatric heart surgery. Keep the prenatal reports and recordings for the centre in Germany.
How AlenMed organises treatment
AlenMed starts with the documents: reports, ultrasound recordings and previous operation notes are translated and sent to paediatric heart centres, whose answer says whether an in-person assessment is needed, whether a catheter procedure or surgery is proposed, how long the stay would be and who must accompany the child.
AlenMed has 86 partner hospitals in 38 cities, 345 doctors and its company office in Munich. A coordinator handles the visa invitation, the appointment and the interpreter, and makes sure the discharge letter names the implanted devices and the drug doses.
This material is for information only and is not an offer. Treatment is decided by the doctor who examines the child in person.