Best Heart Valve Replacement clinics and treatment cost abroad

23 clinics

Overall rating by
verified patients

206 reviews
4.5
The overall rating of clinics where Heart Valve Replacement can be performed, based on Bookimed patients experience.

Best hospitals for aortic valve replacement are listed below. The rating is composed on patient reviews and expert opinion of Bookimed Medical Doctors. Success rate of the operation in leading hospitals is up to 92%. Complete rehabilitation takes up to 3 months.

Heart valve surgery is performed to treat conditions that appear if one or more valves don’t function properly. Such conditions may include loss of breath, loss of consciousness, chest pains. Some people have congenital valve malfunctions. During the operation, valves are either repaired or replaced with artificial ones.

Asklepios Medical Group
Germany, Gamburg
4.4
Description
Reviews
A
Ukraine
The patient was treated of prostatitis

5 minutes of communication with a doctor-600euro plus a hotel-400 add a flight or transport -350 and 300 euros other costs and the result is NULL. It turns out that everyone has staphylococcosis and it is not necessary to treat it! So, JAPANESE MAT'AT, I went with a specific problem, beforehand dropped all the results of the tests and can not immediately refuse and not milk me and waste my time.

Feb 1, 2018
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E
Russian Federation
The patient underwent check-up

Everything is well and clearly organized. accepted professors and heads of departments. The technician is gorgeous. The professor does both the uzi and immediately take the blood, and absolutely does not depend on when and what you ate before that. Several diagnoses delivered at home were not confirmed. Relation to patients, regardless of the nation , equally kind and attentive. Certainly expensive. Sometimes tens of times than would cost the house, but it is better to go through the examination there once in three years than to wander from doctor to doctor for weeks at a time here and as a result get vague diagnoses and an incomprehensible treatment e. Thank you for the organization and efficiency.

Mar 30, 2018
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M
The patient was treated of parkinson"s disease

The doctor was everything I dreamed of and more. The coordinator Eugene Nazarenko was always on time and very accomadating.

Apr 29, 2018
E
Russian Federation
The patient was treated of arrhythmia

I want to express my gratitude to coordinator Asklepios Lydia for organizing the survey. For attention. Help in all matters !! Such specialists are needed in difficult moments of our life! She is in her place!

May 3, 2018
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D
Ukraine
The patient was treated of kidney cancer

From the bottom of my heart I want to thank Professor Gross, as well as all the staff of the Asclepios clinic in Hamburg for their high professionalism, efficiency, sensitivity and attention to patients. About a month ago left an application on the site bookimed, within an hour I was contacted by coordinator Katerina, immediately offered several clinics specializing in oncourology. The choice fell on Asclepios in Hamburg, in particular, Professor Gross. Within a week, thanks to Katerina's efforts, prof. Gross, determined the tactics of treatment and already in a week there was immediate operation. There were some doubts that the nephrectomy could be performed laparoscopically, but the golden hands of prof. Gross know their business. The postoperative period went smoothly, recovered quickly. During the week of the stay, there were no complaints about the work of the staff: attentive, sensitive and affable. Conditions are more than comfortable. The language barrier was not a problem due to the well-coordinated work of the translators Lydia Goncharenko and Vladimir Fissenko. Separately, I want to once again express my gratitude to coordinator Katerina, who was always in touch, quickly resolved all sorts of difficulties.

May 11, 2018
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IRCCS Policlinico San Donato
Italy, Milan
2.0
Description
Gesundheit Nord Bremen (Nord Klinik Allianz)
Overview
Description
Reviews
Doctors
At Gesundheit Nord Bremen heart valve replacement is conducted by a team of cardiac surgeons.The procedure takes place in special operating room in the Cardiology Department. The operation lasts for 2-5 hours, a patient stays under general anesthesia during the surgery. The procedure is considered l...
Al Jebari Nurnina Salam
Bulgaria
Oct 19, 2017

The hospital was good , and I liked the how you feel like there is always support when you need specially when you are travelling to aplace where you know no one . Diana was always in reach when I n...

Dieter Hammel
Dieter Hammel

Cardiac surgeon

A
Bulgaria
The patient underwent diagnostic

The hospital was good , and I liked the how you feel like there is always support when you need specially when you are travelling to aplace where you know no one . Diana was always in reach when I needed something during the prep phase , and Olena was very supportive during the stay . however I think that its better to arrange appointments with doctor at least 30 min meetings before travelling to have some arrangements done with the doctor before travelling . regards

Oct 19, 2017
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Heart surgery is performed when:

  • patient’s condition is getting worse: pain becomes unbearable, risk of heart attack increases;
  • if the state is already severe and regular medications don’t help;
  • patient shows signs of valve dysfunction.

Additional examinations, medications, or lifestyle changes may be prescribed to avoid undergoing the procedure. Valve repair is a preferable alternative to replacement since it allows to preserve the heart and the valve. The procedure is performed on the open heart with the use of heart-lungs bypass machine. The success rate of the operation is up to 92%.

Indications and contraindications for heart valve replacement

Physicians make a decision whether a patient needs valve replacement based on examination results. In case of the following conditions, a doctor may prescribe the valve replacement:

  • shortness of breath;
  • chest pain or discomfort;
  • arrhythmia;
  • loss of stamina;
  • lightheadedness;
  • dizziness;
  • swelling of feet or ankles.

Any patient with known heart issues must be cautious about above mentioned signs and perform check-ups whenever any of them manifest. Early diagnosis is crucial for this disease. Patients who are not aware of their condition, may suffer heart damage due to malfunctioning heart valves. This damage may lead to heart attacks, critical conditions and sudden death.

Contraindications for heart valve operation:

  • oncology;
  • conditions that predispose to bleeding (poor coagulation);
  • HIV;
  • severe infections (including STDs);
  • renal dysfunction.

Types of heart valve operation

Minimally invasive replacement operation

The operation is performed while a patient is under general anesthesia. Heart-lung machine is used to sustain blood flow during the procedure. Minimally invasive surgery is conducted by a team of cardiac surgeons. Physicians utilize long instruments and optical devices that are inserted through a small incisions in patient’s chest. The procedure puts patient's body under less stress and is considered less risky.

Minimally invasive surgery presumes shorter patient hospital stay and quicker recovery.

Transcatheter aortic valve replacement (TAVR/TAVI)

TAVR is a minimally invasive replacement of aortic valve. Sometimes referred to as “implantation”(TAVI). A catheter is utilized in this procedure. During the operation surgeons reach patient’s heart through a small incision in the chest or through the vein. Once in position, replacement valve is either self installed or expanded and set with a balloon. TAVR is used in patients who are at high risk of surgery-related complications. TAVR is also applied for biological valves replacement.

Transcatheter aortic valve replacement (TAVR)

Transcatheter aortic valve replacement

Replacement of the heart valve (operation on the open heart)

In cases when patient’s valve cannot be repaired, a replacement becomes viable. Damaged valve is removed and replaced with the mechanical or biological one. Biological valves are made of cow, pig, or human heart tissue. Biological valves degrade over time, so there will be a need for a replacement in 10-15 years.

Patients with mechanical valves need to take blood-thinning medicine for the rest of their lives to prevent formation of blood clots.

Surgeons will discuss all the details related to the valve type before the operation, including valve replacement surgery cost. Biological valves can be replaced utilizing catheters, without the need of open heart surgery.

Biological valve placement

Bilogical valve

Mechanical valve placement

Mechanical valve

Heart valve repair

Valve repair operation is always chosen over the replacement. This procedure may include:

  • stitching holes in a valve;
  • separating valve flaps that have grown together;
  • tightening annulus muscle ring around the valve;
  • replacement of supporting cords of the valve;
  • reconnecting valve flaps;
  • cutting out excess valve tissue.

Some procedures may be carried out with the use of catheter, guided through patient’s artery. For example, narrowed valve opening is treated with balloon valvuloplasty. During this operation, a balloon attached to the catheter is guided to the narrowed valve. The balloon is then inflated, expanding the valve and allowing blood to pass freely.

Preoperative preparation

Before the operation a patient undergoes standard examinations:

  • ECG;
  • blood and urine tests;
  • chest x-ray.

Patients shouldn’t smoke 2 weeks before the operation, as it increases the risk of complications.

If the operation is not minimally invasive, a patient is administered general anesthesia and connected to heart-lungs bypass machine. After that, the repairs or replacements are done. When it’s over, the heart is started and a patient is disconnected from heart-lung bypass.

The operation takes 2-5 hours to complete, but may take longer if additional procedures are required.

Rehabilitation

Recovery

After the operation, a patient spends first 1-3 days in the Intensive Care Unit (ICU). In-hospital postoperative stay lasts for up to 2 weeks. Physicians may assign a special exercise regimen or rehabilitation program to a patient. During hospital stay patient’s vitals are constantly monitored, any pain syndromes are treated with anabolics, and antibiotics are issued if any signs of infection manifest.

Recovery period varies depending on patient’s overall health state. On average, patients can return to non-physically demanding work 4-6 weeks after the operation.

Home care

Patients are usually dismissed from the hospital 2 weeks after the operation. Physicians recommend commiting to 150 minutes of exercise weekly. It is also advisable that a patient quits smoking and/or drinking. Bad habits are known to reduce replaced valve’s life time and cause complications.

If a patient has received mechanical valve, they should take blood-thinning medicine. Any doctor should be notified about that fact because thinned blood has greater potential for passing infections. Before performing any operations that may cause bleeding, patients need to be administered special antibiotic.

Outlook

The operation is considered low-risk and doesn’t put organism under too much stress. Patients must always stay on lookout for possible signs of heart valve malfunction, because there is a little chance that replaced valve will fail. Usually it happens with biological valves 10-15 years after the operation. The symptoms are typical for heart valve malfunction and include fatigue, short breath, and lightheadedness. In such cases it is advisable to undergo another operation.

Heart valve replacement surgery cost

Heart valve replacement cost is influenced by the following factors:

  • Type of conducted operation. Minimally invasive mitral valve replacement costs more than procedures on the open heart. Heart valve surgery cost also depends on whether a valve will be repaired or replaced.
  • Type of replacement valve. Biological valve replacement cost differs from mechanical aortic valve replacement cost.
  • Patient condition. Tavr procedure cost may increase due to prolonged hospital stay. TAVR cost may also increase due to any additional received medicines.
  • Additional operation. In some cases it may be viable to perform two operations in succession. For example, additional stenting or bypass surgery will increase mitral valve surgery cost.
  • Hospital location. Heart valve repair surgery cost in the USA is 2-3 times higher than in India or Turkey.

How to receive valve replacement abroad?

Submit a request on Bookimed website and our Medical Coordinator will contact you at earliest notice. You will receive answers to all questions regarding cost of mitral valve replacement surgery, what type of procedure is suitable for you, etc. We will also help you to pick the best hospital for heart valve replacement surgery and process all your paperwork. If needed, you will receive assistance in acquiring of visa and transfer.

Kardiolita Private Hospital
Lithuania, Vilnius
4.2
Description
Reviews
E
Russian Federation
The patient was treated of varicocele

Good afternoon. My son was treated in the clinic. There were no complaints during his stay there. And the results of his operation can be assessed only with time.

Jun 23, 2017
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A
Ukraine
The patient underwent coronary stenting

Everything went perfectly. The consultations were held at a high level. Definitely recommend this clinic

Jul 5, 2017
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Y
Ukraine
The patient was treated of aortic stenosis

Thank you! I plan to undergo a check-up in a year.

Jan 27, 2018
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V
Belarus
The patient was treated in this clinic

Excellent!

Mar 12, 2018
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T
Norway
The patient was treated of back pain

Yes, we are very satisfied with the clinic, the doctors are very attentive. The survey was very quick and productive. We are also very satisfied with the treatment. Thank you very much for the doctors and the staff.

Apr 25, 2018
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BLK Super Speciality Hospital
Overview
Description
Reviews
Doctors
In Super Speciality Hospital a team of cardiac surgeons performs heart valve replacement operation in the Cardiology Department. Operation takes 2-5 hours to complete. Other open heart surgeries (e.g. coronary stenting or bypass surgery) may be carried out simultaneously with this operation. А patie...
Nabat
Turkmenistan
Jun 23, 2017

The clinic is good, the doctor is an orthopedist of the highest class, he found the source of the defeat of my hands. Thank them for my health, God grant happiness and all earthly blessings!...

Shahid Mahdi
Shahid Mahdi

Head of the Cardiosurgery Department, Heart Surgeon

N
Turkmenistan
The patient was treated of diabetes type 2

The clinic is good, the doctor is an orthopedist of the highest class, he found the source of the defeat of my hands. Thank them for my health, God grant happiness and all earthly blessings!

Jun 23, 2017
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I
India
The patient was treated in this clinic

The treatment was very good. A qualified doctor, quality equipment, qualified treatment is prescribed. Coordinator reacted very quickly.

Mar 12, 2018
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Fortis Healthcare
India, Gurgaon
4.0
Description
Gleneagles Global Health City (Global Hospital)
Description
Reviews
S
Bangladesh
The patient was treated of ankylosing spondylitis

I am very much satisfied with the cooperation of the employees specially of international desk.e.i. Soumya , Saptak.

Dec 27, 2017
N
Russian Federation
The patient underwent radiofrequency ablation

Everything was at the highest level, happy, thank you all, stay at the clinic for 5 plus

Jan 1, 2018
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G
Russian Federation
The patient underwent liver transplantation

A survey was conducted, during which the state of health at the time of the survey was assessed as good, there is no need for transplantation yet. Recommendations on home, outpatient treatment are given. It is recommended to undergo a second examination after 6 months to assess the dynamics of the state of health.

Jan 31, 2018
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V
Ukraine
The patient was treated of melanoma

I want to thank from the bottom of my heart your company, and in particular a very competent and qualified coordinator-Soyak Alionu for help and advice provided in the process of selecting and treating liver melanoma. Having chosen the country of India and the Global Hospital, we received a consultation and made a diagnosis, thanks to which the oncologist, our doctor, picked up an innovative drug that gave us hope for recovery. We have a diagnosis of grade 4 melanoma of the liver and lung. After returning from India, we undergo further treatment in Ukraine. Believe miracles happen, do not miss your chance, contact Bookimed and they will do their best that you are healthy. RS We are very grateful to Alyona, for helping us in everything from uploading documents to the site and ending with the purchase of tickets for the plane. She worked with us 24 hours a day and if not for her help with our medicine in Ukraine there would be no hope.

Apr 9, 2018
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M
Russian Federation
The patient was treated of bladder cancer

The clinic, in the category "like - do not like", I can not evaluate. Meeting at the airport with an interpreter and transfer to the clinic - standard. Accommodation in the guest house, before the operation, leaves much to be desired. But, who is familiar with India, I do not think for special comfort and does not count, otherwise - to Germany. Immediately the next morning, without delay and delay, a primary appointment with doctors and diagnosis. Prices for a visit from doctors, examinations and tests are very reasonable, commensurate with Moscow or, even lower. Communication with doctors through an interpreter is somewhat difficult, but quite informative and understandable. Knowledge of English will remove all embarrassment, but in general - not critical. The attitude of doctors to the examination and refinement of the diagnosis is "meticulous". After five days - a summary and proposal for a treatment program. Hospitalization, surgery, 3 days in the intensive care unit and postoperative placement in a two-bed room (together with an attendant) for 12 days. And an extract. The level of training, skill and attitude of doctors, from my "ambitious" point of view of the accompanying person, is beyond praise !!! About the surgeon who performed the operation - DR. MURUGANANDHAM K, I want to say that he has "golden hands and heart" !!! The attitude of the average medical personnel, despite the language difficulties, is very friendly. In the intensive care unit was invited immediately after the operation and "woke up" the patient with me. Opening his eyes and seeing his native face after anesthesia - a person "comes alive"! Postoperative treatment and care in the ward are very worthy. Having repeated his own experience in hospitalization, I can not even compare. The account is not in our favor. In fact, treatment in the clinic saved life! This is especially evident now, a year after the treatment. A year ago, options were considered: Germany, Israel and India. In terms of price-quality ratio and recall of acquaintances have chosen treatment in India. And they were not mistaken. The clinic was selected by specialists of the site en.bookimed.com. They also provided a correlation and communication with the clinic. Huge thanks to them !!!

May 12, 2018
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American Heart of Poland Hospitals
Description
Anadolu Medical Center
Turkey, Istanbul
4.9
Description
Reviews
N
Ukraine
The patient was treated of acute lymphoblastic leukemia

We are treating blood cancer in this clinic. I was very surprised by the level of medicine in Turkey, namely in the clinic Anadolu ... Our doctor, Zafer Gulbash, really a specialist - a hematologist with a capital letter. I believe him.... Always on hearing Israel, Germany .... But I did not regret for a minute that I believed the consultants Bookimed, and trusted this clinic.

Jun 16, 2017
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L
Kazakhstan
The patient was treated in this clinic

In April, my mother discovered a pancreatic cancer with metastases to the liver. The coordinator bookimed Kristina Zadorozhnaya sent us to Anadol, for which she is very grateful! Mom is currently undergoing treatment, there are improvements. I want to note the high professionalism, as well as the great opportunities for treatment and quality improvement life in the clinic Anadolu. Huge gratitude to doctors, a group of translators and coordinator! Do not hesitate and do not waste time, trust the team of professionals! We are from Kazakhstan.

Sep 8, 2017
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A
Ukraine
The patient was treated of prostate cancer

It is clear that there can be practically no guarantees in life, and as for health-healing, it is generally high matter, but when dealing with Bukimed and the clinic recommended by them, we received exhaustive consultations, professional examinations and appointments. For that very grateful!

Dec 29, 2017
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B
Russian Federation
The patient was treated of pancreatic cancer

You can talk about treatment after receiving the results, a professor who examined me and doctors cause trust. I can recommend a clinic. Excellent organization of examination and treatment, there are blunders, but there are not many of them. Language barriers should be taken into account. Eugene

Feb 3, 2018
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Sourasky Medical Center
Israel, Tel Aviv
4.6
Description
Reviews
E
Russian Federation
The patient was treated of epilepsy

We passed the examination in the clinic in August 2017. All the procedures were completed within 3 days, including a doctor's consultation .. We were accompanied everywhere .. We were satisfied with the services, although we hoped that the cause of the illness would be clarified .. We will recommend the clinic and bukimed ..

Aug 30, 2017
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Y
Russian Federation
The patient was treated of epilepsy

Dr. Uri Kremer is a competent specialist and a good person. Accompanying people are also friendly. In general, everything is fine, without claims.

Dec 13, 2017
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T
Russian Federation
The patient was treated of multiple sclerosis

We really liked your Clinic. The best impression of the doctor. After receiving the tests and recommendations I'll write a more detailed review. Thank you very much for the services you provided and for your sensitive attitude.

Jan 18, 2018
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O
Russian Federation
The patient was treated of breast cancer

Treatment is a long and very great influence has the attitude of the host and doctors. The attitude is very good, sincere.This is very important. All our requests and wishes have been fulfilled. I am satisfied that I chose this medical center. Treatment in the clinic I will recommend to others.

Jan 30, 2018
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L
Russian Federation
The patient was treated of breast cancer

Good

Mar 24, 2018
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Recent reviews
M
Russian Federation
The patient was treated of bladder cancer

The clinic, in the category "like - do not like", I can not evaluate. Meeting at the airport with an interpreter and transfer to the clinic - standard. Accommodation in the guest house, before the operation, leaves much to be desired. But, who is familiar with India, I do not think for special comfort and does not count, otherwise - to Germany. Immediately the next morning, without delay and delay, a primary appointment with doctors and diagnosis. Prices for a visit from doctors, examinations and tests are very reasonable, commensurate with Moscow or, even lower. Communication with doctors through an interpreter is somewhat difficult, but quite informative and understandable. Knowledge of English will remove all embarrassment, but in general - not critical. The attitude of doctors to the examination and refinement of the diagnosis is "meticulous". After five days - a summary and proposal for a treatment program. Hospitalization, surgery, 3 days in the intensive care unit and postoperative placement in a two-bed room (together with an attendant) for 12 days. And an extract. The level of training, skill and attitude of doctors, from my "ambitious" point of view of the accompanying person, is beyond praise !!! About the surgeon who performed the operation - DR. MURUGANANDHAM K, I want to say that he has "golden hands and heart" !!! The attitude of the average medical personnel, despite the language difficulties, is very friendly. In the intensive care unit was invited immediately after the operation and "woke up" the patient with me. Opening his eyes and seeing his native face after anesthesia - a person "comes alive"! Postoperative treatment and care in the ward are very worthy. Having repeated his own experience in hospitalization, I can not even compare. The account is not in our favor. In fact, treatment in the clinic saved life! This is especially evident now, a year after the treatment. A year ago, options were considered: Germany, Israel and India. In terms of price-quality ratio and recall of acquaintances have chosen treatment in India. And they were not mistaken. The clinic was selected by specialists of the site en.bookimed.com. They also provided a correlation and communication with the clinic. Huge thanks to them !!!

May 12, 2018
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A
Slovenia
The patient was treated of retinal detachment

I was very pleased with everything at the clinic and the coordinator Mariana Zaiarna. The overall good impression was ruined by mr. Roman.

May 11, 2018
D
Ukraine
The patient was treated of kidney cancer

From the bottom of my heart I want to thank Professor Gross, as well as all the staff of the Asclepios clinic in Hamburg for their high professionalism, efficiency, sensitivity and attention to patients. About a month ago left an application on the site bookimed, within an hour I was contacted by coordinator Katerina, immediately offered several clinics specializing in oncourology. The choice fell on Asclepios in Hamburg, in particular, Professor Gross. Within a week, thanks to Katerina's efforts, prof. Gross, determined the tactics of treatment and already in a week there was immediate operation. There were some doubts that the nephrectomy could be performed laparoscopically, but the golden hands of prof. Gross know their business. The postoperative period went smoothly, recovered quickly. During the week of the stay, there were no complaints about the work of the staff: attentive, sensitive and affable. Conditions are more than comfortable. The language barrier was not a problem due to the well-coordinated work of the translators Lydia Goncharenko and Vladimir Fissenko. Separately, I want to once again express my gratitude to coordinator Katerina, who was always in touch, quickly resolved all sorts of difficulties.

May 11, 2018
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E
Russian Federation
The patient was treated of post-traumatic facial nerve paresis

We came from another country and not from a neighboring city, I would like to of course so that the doctors immediately accepted and did not expect them for hours. After all, we had all the arrangements in advance.

May 10, 2018
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D
Ukraine
The patient underwent hip replacement

I went through the replacement of the hip joint in the MALVASINKA Clinic with subsequent rehabilitation from 18.03.2018 to 11.04.2018. After finding the house for 4 weeks, he systematized his initial and final impression. His stay and the quality of treatment, rehabilitation in the Clinic Malvazinki would like to appreciate in the following way: 1. PLUSES: - Excellent operating surgeon Vladislav Hospodar; - Excellent and very professionally attentive physiotherapist Dana Braxova; - Responsive nurses, especially Andrea. 2. MINUSES: BASIC FAT MINUS - ASSISTANCE OF CONSERVER TRANSFERS UNDER THE IMMEDIATE THE MANAGEMENT OF OLGA SKATKOVA (Olga SKATKOVA) - As it is written in one of the previous reviews - "Everything is almost fine before it paid off.  Then no one has anything to do with you! "- I absolutely agree, after leaving all my letters completely  were ignored by the concierge O. Skatkova, despite the status of "Delivered" and "Viewed." - In particular, the extract / anamnesis was issued without translation, although the coordinators of the clinic promised that  the translation will be sent in 2-3 days after discharge, without results, wait a month (!!!!!). After 3 weeks of waiting and inquiries received a short answer that they have "force majeure" without any specifics when the translation of the statement will be made, and the time allowed for the registration of the disability goes and it is not my dimensionless,  I no longer see the point in writing. A reference image sent after 6 weeks after the operation (on the recommendation of the clinic's specialists, to determine the progress of rehabilitation and the time when it will be possible to refuse crutches) was sent last week, just after a 6-week period, as ordered, see the result above - the status of the message to O. Skatkova "Delivered" and "Viewed" the reaction is ZERO. The subsequent reminder of the picture and the translation of the extract is still left without any answer. - If "According to the rules of the clinic, concierge-interpreters visit every patient for 1-2 hours a day for  translation into Russian of a doctor's visit and individual physiotherapy, "then there were days when they did not visit me at all or came to me  with a significant delay (in particular - Elena), which entailed the admission or reduction of rehabilitation procedures, changing the schedule, etc. - The rehabilitation is rather weak, at first there were only 2 procedures a day, physiotherapy individual and group, after my repeated  requests, during the third week of stay, more procedures were added, however it was already the final week and, for example, a massage duration of 10 minutes a session, was only 2 times for the entire period of rehabilitation. I recommend to all who plan treatment, to keep this moment under the control and remind the concierges about the need to add to the schedule of additional procedures, for some reason they themselves are not particularly concerned about this, despite the rather large, in general, cost of rehabilitation. Two of my friends have already refused treatment in this clinic, after my recall, in favor of German clinics, where although slightly and more expensive, but the services are performed in full and without extra reminders.

May 9, 2018
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