André Rüffer1, Jin Ye Yeo2
1Department of Pediatric and Congenital Cardiac Surgery, University Hospital Aachen (RWTH), Aachen, Germany; 2TP Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. TP Editorial Office, AME Publishing Company. Email: editor@thetp.org.
This interview can be cited as: Rüffer A, Yeo JY. Meeting the Editorial Board Member of TP: Prof. André Rüffer. Transl Pediatr. 2025. Available from: https://tp.amegroups.org/post/view/meeting-the-editorial-board-member-of-tp-prof-andr-eacute-r-uuml-ffer.
Expert introduction
Prof. André Rüffer (Figure 1) was born in Würselen, Germany, and grew up in Aachen and Berlin. After graduating from high school in 1990, he studied human medicine at Charles University in Prague, Czech Republic. Between 1997 and 2005 he absolved his adult cardiac surgery training at the Heart Center Cottbus, Germany, and changed to the University Hospital Hamburg-Eppendorf, Germany, in 2006 for a pediatric cardiac surgery fellowship. In 2008 he became deputy clinical director and senior consultant for pediatric cardiac surgery at the University Hospital Erlangen, Germany. Between 2018 and 2021 he was head of section for congenital cardiac surgery back at the University Hospital Hamburg-Eppendorf. Since 2021 he has been Chairman of the Pediatric and Congenital Cardiac Surgery Department at the University Hospital (Uniklinik) RWTH Aachen, Germany.
Prof. Rüffer's spectrum includes the entire complex of cardiac surgery on children and adults (EMAH) with congenital heart defects, including aortic arch, tracheal, and minimally invasive surgery. He has a certificate for pediatric cardiac surgery and surgery for congenital heart defects by the German Society for Cardiothoracic and Vascular Surgery (DGTHG). In 2018, he was honored to receive the Franz Köhler Prize from the DGTHG for his research activities in the field of organ protection. Since 2016 he has been a member of the guidelines committee of the German Society for Pediatric Cardiology and since 2023 head of the workforce for surgery of congenital heart defects and pediatric cardiac surgery of the DGTHG.
Figure 1 Prof. André Rüffer
Interview
TP: What inspired you to specialize in cardiac surgery and focus on congenital heart defects?
Prof. Rüffer: My first exposure to congenital cardiac surgery was at the Leipzig meeting in 2004, organized by Martin Kostelka, which brought together many leading surgeons and pediatric cardiologists. While I was fascinated by the field, this initial interest was further deepened after attending a morphology course in London by Robert Anderson. My first hands-on experience in the operating room came when I had the opportunity to visit Dr. Hübler at the pediatric cardiac surgery unit of the German Heart Center in Berlin. Shortly thereafter, I had the privilege of meeting Prof. Robert Cesnjevar at the University Hospital Hamburg-Eppendorf, who became both my mentor and dear friend.
TP: What are the most significant challenges you face in treating congenital heart defects? How do you overcome them? If not, what are some of the most critical areas of research that are needed to overcome these challenges?
Prof. Rüffer: The treatment of congenital heart defects presents several significant challenges, primarily due to the vast variety of congenital cardiac malformations and the need for tailored approaches to their individual surgical treatment. Each defect has its unique set of anatomical and physiological considerations, which demands precise diagnosis and personalized surgical strategies.
One of the most critical challenges is ensuring effective organ protection during surgery. Since many of these surgeries involve young, often fragile patients, preserving the function of vital organs—especially the brain and kidneys—during the procedure is crucial. This involves advanced techniques in cardiopulmonary bypass and careful management of hemodynamics and oxygenation to minimize the risk of ischemic damage.
Additionally, the move towards minimally invasive surgery has presented both opportunities and challenges. While minimally invasive approaches offer benefits like reduced recovery times and less trauma for the patient, they also require specialized equipment and highly skilled surgeons. The technical demands of these surgeries can sometimes complicate the treatment of complex malformations, whereas traditional open surgery might offer a more straightforward solution.
To overcome these challenges, ongoing research into advanced surgical techniques and better organ protection methods is essential. Innovations in tissue engineering, stem cell therapy, and more refined imaging technologies will likely play pivotal roles in improving outcomes for patients with congenital heart defects. Furthermore, the development of more precise minimally invasive techniques tailored to specific defects is a critical area of research that holds promise for the future of congenital cardiac surgery.
TP: You received the Franz Köhler Prize for your research in organ protection. Can you share more about this research and how it has impacted the field since then?
Prof. Rüffer: Receiving the Franz Köhler Prize for my research in organ protection was a significant honor. New developments in cardiopulmonary bypass techniques during aortic arch repair enable a combination of simultaneous antegrade cerebral, myocardial, and distal aortic perfusion, so-called “goal-directed perfusion”. A key focus of my research, on the one hand, has been the innovative approach of aortic arch repair on the beating heart—aptly termed “let it beat!”. On the other hand, modified blood cardioplegia was validated in an experimental setting and introduced into clinical practice. This research has greatly impacted congenital cardiac surgery, refining surgical protocols and improving outcomes.
TP: What recent advancements in cardiopulmonary bypass and organ protection do you see as game-changers in pediatric cardiac surgery?
Prof. Rüffer: Goal-directed perfusion techniques have been critical in maintaining optimal organ perfusion, minimizing ischemic damage, and improving post-operative recovery.
TP: How do you see artificial intelligence (AI) and machine learning shaping the future of congenital cardiac surgery?
Prof. Rüffer: AI and machine learning hold tremendous potential to transform the field of congenital cardiac surgery across multiple domains. During preoperative planning, advanced imaging analysis powered by AI can enable more accurate and individualized anatomical reconstructions, especially in complex congenital heart defects where variability is the norm. By integrating 3D modeling and predictive analytics, surgeons can virtually simulate procedures, anticipate complications, and tailor surgical strategies to each patient’s unique physiology. In the intraoperative setting, AI could monitor perfusion parameters, anticipate adverse events, or assist with real-time decision-making. Postoperatively, predictive models based on large datasets can identify patients at higher risk of complications, optimize ICU management, and personalize follow-up protocols. Importantly, while AI will not replace the nuanced judgment of an experienced congenital cardiac surgeon, it will increasingly serve as a powerful augmentative tool—enhancing precision, safety, and outcomes, particularly in high-risk pediatric populations.
TP: As an Editorial Board Member, what are your aspirations and expectations for TP?
Prof. Rüffer: My expectation for the journal is to become a landmark reference regarding surgery and treatment of congenital heart disease.