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Intensivmedizin up2date 2013; 09(02): 157-172
DOI: 10.1055/s-0033-1344068
Internistische Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Intensivmedizinische Herausforderungen bei TAVI und MitraClip

Tobias Wengenmayer
,
Manfred Zehender
,
Christoph Bode
,
Constantin von zur Mühlen
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Publikationsverlauf

Publikationsdatum:
15. Mai 2013 (online)

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Kernaussagen

  • Die konservative Therapie der AI und der MI ist rein symptomatisch und verlängert die Überlebensdauer nicht.

  • Die interventionelle Versorgung der Aorten- und Mitralklappe ermöglicht es, auch Patienten mit erhöhtem Operationsrisiko suffizient zu versorgen.

  • Die bisherigen Ergebnisse der interventionellen Klappenrekonstruktionen sind exzellent.

  • Herausfordernd ist einerseits die Intervention selbst, andererseits aber auch die optimale peri- und postinterventionelle Versorgung der Patienten.

  • Die Kenntnis möglicher Komplikationen und Besonderheiten der Interventionen ist essenziell, um Probleme rechtzeitig zu erkennen und entsprechend handeln zu können.

 

  • Literatur

  • 1 Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012; 33: 2451-2496
    CrossrefPubMedGoogle Scholar
  • 2 Mirabel M et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?. Eur Heart J 2007; 28: 1358-1365
    CrossrefPubMedGoogle Scholar
  • 3 Stortecky S et al. Evaluation of Multidimensional Geriatric Assessment as a Predictor of Mortality and Cardiovascular Events After Transcatheter Aortic Valve Implantation. JCIN 2012; 5: 489-496
    PubMedGoogle Scholar
  • 4 Stewart BF et al. Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study. J Am Coll Cardiol 1997; 29: 630-634
    CrossrefPubMedGoogle Scholar
  • 5 Otto CM et al. Prospective study of asymptomatic valvular aortic stenosis. Clinical, echocardiographic, and exercise predictors of outcome. Circulation 1997; 95: 2262-2270
    CrossrefPubMedGoogle Scholar
  • 6 Bonow RO et al. Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). Circulation 1998; 98: 1949-1984
    CrossrefPubMedGoogle Scholar
  • 7 European System for Cardiac Operative Risk Evaluation. Scoring System. Im Internet: http://www.euroscore.org/euroscore_scoring.htm Stand: 31.03.2013
    PubMedGoogle Scholar
  • 8 Society of Thoracic Surgeons. Online STS risk calculator. Im Internet: http://riskcalc.sts.org/STSWebRiskCalc273/de.aspx Stand: 31.03.2013
    PubMedGoogle Scholar
  • 9 Reinöhl J, von zur Mühlen C, Moser M et al. TAVI 2012: state of the art. J Thromb Thrombolysis 2012; DOI: 10.1007/s11239-012-0825-4.
    PubMedGoogle Scholar
  • 10 Smith CR et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 2011; 364: 2187-2198
    CrossrefPubMedGoogle Scholar
  • 11 Makkar RR, Fontana GP, Jilaihawi H et al. Transcatheter Aortic-Valve Replacement for Inoperable Severe Aortic Stenosis. N Engl J Med 2012; DOI: 10.1056/NEJMoa1202277.
    PubMedGoogle Scholar
  • 12 Leon MB et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010; 363: 1597-1607
    CrossrefPubMedGoogle Scholar
  • 13 Thomas M et al. One-Year Outcomes of Cohort 1 in the Edwards SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) Registry: The European Registry of Transcatheter Aortic Valve Implantation Using the Edwards SAPIEN Valve. Circulation 2011; 124: 425-433
    CrossrefPubMedGoogle Scholar
  • 14 Yamamoto M et al. Effect of local anesthetic management with conscious sedation in patients undergoing transcatheter aortic valve implantation. Am J Cardiol 2013; 111: 94-99
    CrossrefPubMedGoogle Scholar
  • 15 Dehédin B et al. Anesthesia and perioperative management of patients who undergo transfemoral transcatheter aortic valve implantation: an observational study of general versus local/regional anesthesia in 125 consecutive patients. J Cardiothorac Vasc Anesth 2011; 25: 1036-1043
    CrossrefPubMedGoogle Scholar
  • 16 Krayenbuehl HP et al. Left ventricular myocardial structure in aortic valve disease before, intermediate, and late after aortic valve replacement. Circulation 1989; 79: 744-755
    CrossrefPubMedGoogle Scholar
  • 17 Christakis GT et al. Left ventricular mass regression early after aortic valve replacement. ATS 1996; 62: 1084-1089
    PubMedGoogle Scholar
  • 18 Weidemann F et al. Impact of myocardial fibrosis in patients with symptomatic severe aortic stenosis. Circulation 2009; 120: 577-584
    CrossrefPubMedGoogle Scholar
  • 19 Blitz LR, Gorman M, Herrmann HC. Results of aortic valve replacement for aortic stenosis with relatively low transvalvular pressure gradients. Am J Cardiol 1998; 81: 358-362
    CrossrefPubMedGoogle Scholar
  • 20 Kodali SK, Williams MR, Smith CR et al. Two-Year Outcomes after Transcatheter or Surgical Aortic-Valve Replacement. N Engl J Med 2012; DOI: 10.1056/NEJMoa1200384.
    PubMedGoogle Scholar
  • 21 Gotzmann M et al. Long-term outcome of patients with moderate and severe prosthetic aortic valve regurgitation after transcatheter aortic valve implantation. Am J Cardiol 2012; 110: 1500-1506
    CrossrefPubMedGoogle Scholar
  • 22 Kahlert P et al. Silent and apparent cerebral ischemia after percutaneous transfemoral aortic valve implantation: a diffusion-weighted magnetic resonance imaging study. Circulation 2010; 121: 870-878
    CrossrefPubMedGoogle Scholar
  • 23 Erkapic D et al. Electrocardiographic and further predictors for permanent pacemaker requirement after transcatheter aortic valve implantation. Europace 2010; 12: 1188-1190
    CrossrefPubMedGoogle Scholar
  • 24 Chieffo A et al. Transcatheter Aortic Valve Implantation With the Edwards SAPIEN Versus the Medtronic CoreValve Revalving System Devices: A Multicenter Collaborative Study: The PRAGMATIC Plus Initiative (Pooled-RotterdAm-Milano-Toulouse In Collaboration). J Am Coll Cardiol 2013; 61: 830-836
    CrossrefPubMedGoogle Scholar
  • 25 Roten L et al. Incidence and Predictors of Atrioventricular Conduction Impairment After Transcatheter Aortic Valve Implantation. AJC 2010; 106: 1473-1480
    CrossrefPubMedGoogle Scholar
  • 26 Strauch JT et al. Minimally invasive transapical aortic valve implantation and the risk of acute kidney injury. Ann Thorac Surg 2010; 89: 465-470
    CrossrefPubMedGoogle Scholar
  • 27 Bagur R et al. Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. Eur Heart J 2010; 31: 865-874
    CrossrefPubMedGoogle Scholar
  • 28 Hayashida K et al. Transfemoral aortic valve implantation new criteria to predict vascular complications. JACC Cardiovasc Interv 2011; 4: 851-858
    CrossrefPubMedGoogle Scholar
  • 29 Alvarez JM et al. Repairing the degenerative mitral valve: ten- to fifteen-year follow-up. J Thorac Cardiovasc Surg 1996; 112: 238-247
    CrossrefPubMedGoogle Scholar
  • 30 Ambler G et al. Generic, simple risk stratification model for heart valve surgery. Circulation 2005; 112: 224-231
    CrossrefPubMedGoogle Scholar
  • 31 Ling LH et al. Clinical outcome of mitral regurgitation due to flail leaflet. N Engl J Med 1996; 335: 1417-1423
    CrossrefPubMedGoogle Scholar
  • 32 Trichon BH, Felker GM, Shaw LK et al. Relation of frequency and severity of mitral regurgitation to survival among patients with left ventricular systolic dysfunction and heart failure. Am J Cardiol 2003; 91: 538-543
    CrossrefPubMedGoogle Scholar
  • 33 Carabello BA. The current therapy for mitral regurgitation. J Am Coll Cardiol 2008; 52: 319-326
    CrossrefPubMedGoogle Scholar
  • 34 Warnes CA et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). Circulation 2008; 118: 2395-2451
    CrossrefPubMedGoogle Scholar
  • 35 Haan CK, Cabral CI, Conetta DA et al. Selecting patients with mitral regurgitation and left ventricular dysfunction for isolated mitral valve surgery. Ann Thorac Surg 2004; 78: 820-825
    CrossrefPubMedGoogle Scholar
  • 36 Chikwe J et al. A propensity score-adjusted retrospective comparison of early and mid-term results of mitral valve repair versus replacement in octogenarians. Eur Heart J 2011; 32: 618-626
    CrossrefPubMedGoogle Scholar
  • 37 Alfieri O et al. The double-orifice technique in mitral valve repair: a simple solution for complex problems. J Thorac Cardiovasc Surg 2001; 122: 674-681
    CrossrefPubMedGoogle Scholar
  • 38 Feldman T, Foster E, Glower DD et al. Percutaneous Repair or Surgery for Mitral Regurgitation. N Engl J Med 2011; DOI: 10.1056/NEJMoa1009355.
    PubMedGoogle Scholar
  • 39 Whitlow PL et al. Acute and 12-Month Results With Catheter-Based Mitral Valve Leaflet Repair The EVEREST II (Endovascular Valve Edge-to-Edge Repair) High Risk Study. J Am Coll Cardiol 2012; 59: 130-139
    CrossrefPubMedGoogle Scholar
  • 40 Franzen O et al. MitraClip therapy in patients with end-stage systolic heart failure. Eur J Heart Fail 2011; 13: 569-576
    CrossrefPubMedGoogle Scholar
  • 41 Biner S et al. Acute effect of percutaneous MitraClip therapy in patients with haemodynamic decompensation. Eur J Heart Fail 2012; 14: 939-945
    CrossrefPubMedGoogle Scholar
  • 42 Gaemperli O et al. Acute haemodynamic changes after percutaneous mitral valve repair: relation to mid-term outcomes. Heart 2011; 98: 126-132
    PubMedGoogle Scholar