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Kardiologie up2date 2021; 17(03): 251-263
DOI: 10.1055/a-1074-8408
Herzklappenerkrankungen

Einführung in die chirurgische Therapie von Aortenklappenerkrankungen

Matthias Siepe
,
Wolfgang Zeh
,
Emmanuel Zimmer
,
Sami Kueri
,
Paul-Cătălin Puiu
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Aortenklappenerkrankungen werden mit steigender Zahl chirurgisch behandelt. Von offenen chirurgischen Aortenklappenersatzverfahren und rekonstruktiven Maßnahmen profitieren immer mehr jüngere Patienten mit Aortenklappeninsuffizienz oder prothetischen Aortenklappen. Indikationen, Techniken und Ergebnisse der chirurgischen Möglichkeiten und auch die Therapie der Aortenklappenendokarditis oder Prothesenendokarditis werden im Folgenden beleuchtet.
Kernaussagen

  • Insuffizienz der Aortenklappe kann in sehr vielen Fällen mit einer haltbaren Rekonstruktion der Klappe behandelt werden.

  • Bei der viel häufigeren Aortenklappenstenose ist fast immer ein Ersatz der Klappe notwendig.

  • Als Klappenprothesen gibt es neben den klassischen mechanischen und biologischen Prothesen auch neue biologische Herzklappenprothesen.

  • Neue biologische Prothesen sind entweder sehr schnell und minimalinvasiv einsetzbar oder verfügen durch eine Oberflächenbehandlung über besonders lange Haltbarkeit.

  • Für ältere oder Risikopatienten ist die Behandlung mit einer kathetergestützten Aortenklappe (TAVI) eine segensreiche und minimalinvasive Prozedur.

  • TAVI-Prothesen können auch in nicht mehr funktionsfähige biologische Herzklappenprothesen implantiert werden.

  • Eine individuelle Auswahl des am besten geeigneten Verfahrens für den jeweiligen Patienten kann im Heart Team in geeigneten Zentren mit Expertise in allen Bereichen der Aortenklappenbehandlung geleistet werden.

Schlüsselwörter

Aortenklappe - Insuffizienz - Klappenersatz - Bioprothesen - TAVI - Operation - Rekonstruktion


Publication History

Article published online:
14 September 2021

© 2021. Thieme. All rights reserved.

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