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Erschienen in: Wiener Medizinische Wochenschrift 15-16/2012

01.08.2012 | review

Kathetergestützter Aortenklappenersatz: eine neue therapeutische Option der Aortenklappenstenose?

verfasst von: Dr. Lukas Jaroslaw Motloch, Sara Reda, Dennis Rottlaender, Matthias Heigert, Uta C. Hoppe

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 15-16/2012

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Zusammenfassung

30 % aller Patienten mit einer signifikanten Aortenstenose werden aufgrund eines hohen Operationsrisikos nicht mit einem konservativen Aortenklappenersatz behandelt. Eine minimalinvasive Alternative für diese Patienten bietet der kathetergestützte Aortenklappenersatz (transcatheter aortic valve replacement; TAVI). Man unterscheidet bei den minimalinvasiven Verfahren grundsätzlich den transfemoralen und den transapikalen Aortenklappenersatz. Bei ersterem werden die auf einen Stentrahmen aufgebrachten Klappen kathetergesteuert über die Femoralgefäße implantiert. Der Zugangsweg für zweiteren ist eine linksanterolaterale Mini-Thorakotomie im fünften Interkostalraum. Die häufigsten Komplikationen sind Gefäß- und Blutungskomplikationen, ein neu aufgetretener höhergradiger AV-Block, die Entwicklung einer paravalvulären Insuffizienz, ein akutes Nierenversagen, ein Schlaganfall sowie eine TIA. Erste Studien in einem Hochrisikokollektiv zeigen gute Ergebnisse. Damit bietet die TAVI Hochrisikopatienten eine sinnvolle Therapie. Weitere Studien zum Langzeitverlauf der Patienten stehen noch aus.
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Metadaten
Titel
Kathetergestützter Aortenklappenersatz: eine neue therapeutische Option der Aortenklappenstenose?
verfasst von
Dr. Lukas Jaroslaw Motloch
Sara Reda
Dennis Rottlaender
Matthias Heigert
Uta C. Hoppe
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 15-16/2012
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-012-0136-6