Before your stay

Dental check-up prior to heart valve surgery: why is it important?

It is important that you have a dental check-up if you are scheduled to undergo heart valve surgery. Should your dentist determine that you have a periapical granuloma, this should be treated prior to your undergoing heart valve surgery. A periapical granuloma is caused by a bacterial infection and, given its characteristic radiographic appearance, which is characterized by a brighter appearance around the tip of the root, it can be easily identified by your dentist on an x-ray image.

As the area around the root tip contains small clusters of granulated infected tissue (granuloma), it is essential for any affected teeth to be treated prior to heart valve surgery. In most cases, this treatment will involve the removal of the affected tooth. As this results in the granuloma being opened up, the granuloma can then be emptied using a sharp, spoon-shaped instrument. This procedure will eradicate any bacterial infection. In some cases, the tooth can be treated by cutting away infected parts of the root, thus eliminating any infection on the inside of the tooth. This is known as root canal surgery. Your dentist will be able to advise you on the best treatment option available in your particular case.

The reason why treatment is required is that there is a risk of bacterial infiltration of the jaw, which could result in bacteria entering the bloodstream during or after heart valve surgery. This could lead to bacteria attaching to the newly-implanted heart valve (prosthetic valve endocarditis), which could then result in infection and may lead to a life-threatening situation for the patient:

• Sepsis (blood poisoning).
• Infection is certain to result in the prosthetic valve becoming faulty, with malfunctions affecting processes that are essential to normal heart function and normally ensure that blood flows in the right direction.
• Pieces of bacterial vegetation can break off and cause blockages in major arteries, causing stroke, kidney failure and liver failure.
• Abscesses can develop inside the heart. These can weaken the walls separating the ventricles or the walls between the ventricles and the aorta, which can result in holes forming and blood flowing in the wrong direction. If this type of defect is only a minor one, the blood's velocity may result in mechanical damage being caused to red blood cells, while a large defect may lead to large amount of blood flowing in the wrong direction, placing excess pressure on the heart and leading to heart failure.

All of the above complications can only be treated with further surgery, and the overall risk to the patient will be high as a result. This is why the general advice to patients is to have any dental infections treated prior to undergoing surgery that involves having one or more of their heart valves repaired or replaced. The same advice of course applies to chronic infections in other parts of the body (e.g. the sinuses).



Exceptions are only ever made in cases where there is an immediate danger to the life of the patient. The risk of developing endocarditis - and the above-named consequences of such an infection - will then have to be weighed against the real risk of the patient suffering acute heart failure while waiting for surgery, and will result in the patient being accepted for surgery in spite of an increased risk of infection.

Before your procedure

Your cardiologist will refer you by telephone and provide us with the relevant documentation. At the same time, any images obtained during cardiac catheterization will be transmitted to us electronically. We will schedule a date for your admission and inform your cardiologist. If you prefer, you may contact us directly to find out the date of your admission.

You may have a light breakfast on the morning of your admission.

We would ask that you continue taking your medication as normal. Unless otherwise directed, this also includes any anticoagulant (blood-thinning) medication you may be taking.

Upon arrival at the Department of Heart Surgery

On the day of your admission, please ensure that you arrive at the Heart Center between 09:30 and 10:00 am.

Patient Registration is located next to the Main Reception desk on the ground floor of the hospital. Once you have completed the registration process, please make your way up to Ward 8 on the 3rd floor of the building.

Changes in the law regulating how treatment in hospitals is financed (Krankenhausfinanzierungsreformgesetz, KHRG) mean that hospitals are now responsible for collecting any additional charges as per Section 39, subsection 4 of the SGB V (Social Law Book). This means that patients insured with statutory health insurance providers have to pay a contribution of 10.00 euros per calendar day, and up to a maximum of 28 days per calendar year.

Please ensure that these additional charges for inpatient treatment are paid before you leave the Brandenburg Heart Center. Payment can be made either at the Payment Point (Kasse)/ Patient Admissions (Patientenaufnahme) or at the Reception desk.

Checklist - what will you need during your stay in our Department of Heart Surgery?

• Nightwear
• Underwear
• Slippers
• Bathrobe / Tracksuit
• Towels
• Toiletries
• Please refrain from bringing valuable items. 
Should you feel that this is unavoidable, please ensure that you hand any valuable items to a ward sister so that they may be kept in a safe.
• You may wish to bring a small amount of cash so that you can visit the cafeteria or buy a newspaper. You may also wish to purchase a telephone card to ensure that you can make and receive calls from your room.

Visiting hours in the Department of Heart Surgery

If you are planning on visiting a member of your family staying with us, you can do so at any time.

If you are visiting the Observation Unit, we would kindly request that you observe the following visiting hours: 2:30 pm to 5:00 pm (7 days a week).

Please note that a maximum of 2 visitors per patient will be allowed during visiting hours. Children under 14 years of age will only be allowed onto the ward in exceptional circumstances.

Telephone numbers for the Department of Heart Surgery

You may call us at any time.

• Ward 5
  T: +49 3338 694500 or 694501
• Ward 8
  T: +49 3338 694800 or 694801
• Intensive Care Unit
  T: +49 3338 694100 or 69410

How to contact the Department of Heart Surgery

Immanuel Klinikum Bernau Herzzentrum Brandenburg (Brandenburg Heart Center)

Ladeburger Straße 17
16321 Bernau
bernau.herzchirurgie@immanuel.de