Aortenklappe: wann konservativ, wann operativ, wann interventionell?

Aortenklappenvitien gehören zu den häufigsten erworbenen Herzklappen-Erkrankungen. Der chirurgische Aortenklappen-Ersatz und ein konservatives Vorgehen waren lange die einzigen Therapien. Inzwischen stehen Katheter-basierte Klappenprothesen zur Verfügung, die zunehmend auch bei jüngeren Patienten mit geringerem OP-Risiko eingesetzt werden. Dieser Artikel gibt einen Überblick über die Therapieoptionen und die Wahl der optimalen Therapieform.

Abstract

Aortic valve disease, especially aortic valve stenosis, is one of the most common acquired valve diseases and is associated with increased mortality and morbidity. Due to the rising age of the population, the prevalence of aortic valve stenosis has increased sharply in recent years. For many years, surgical aortic valve replacement was the only available therapy beside the conservative approach. With the implantation of the first catheter-based valve prosthesis in 2002, the era of transcatheter aortic valve implantation began. While this therapy was initially limited to inoperable and high-risk patients, the indication has been increasingly extended to younger patients with lower surgical risk over the past years. However, choosing the optimal therapy modality and determining the ideal timing of treatment can often be challenging in clinical practice. The aim of this article is to provide an overview of the different therapy modalities, the decision-making process and current therapy guidelines.

Schlüsselwörter

Aortenklappen-Stenose - Aortenklappen-Insuffizienz - Transkatheter-Aortenklappen-Implantation - chirurgischer Aortenklappen-Ersatz

Key words

aortic valve stenosis - aortic valve regurgitation - transcatheter aortic valve implantation - surgical aortic valve replacement

Publikationsverlauf

Artikel online veröffentlicht:
15. August 2022

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