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DOI: 10.1055/s-0029-1241909
© Georg Thieme Verlag KG Stuttgart · New York
Qualität der chirurgischen Behandlung von Aortenklappenvitien
Welche Verbesserungen sind von Hybridklappen zu erwarten?Quality in aortic valve replacement How good have hybrid valves have to be?Publication History
eingereicht: 29.7.2009
akzeptiert: 13.8.2009
Publication Date:
15 October 2009 (online)
![](https://www.thieme-connect.de/media/dmw/2009S06/lookinside/thumbnails/10.1055-s-0029-1241909-1.jpg)
Zusammenfassung
Die Entwicklung neuer Hybridklappen legt eine aktuelle Bestandsaufnahme der konventionellen Verfahren nahe. Die chirurgische Therapie der Aortenvitien umfasst ein Spektrum an Verfahren, die mit geringem Risiko eingesetzt werden können. Der Euroscore überschätzt das Risiko erheblich, auch der STS-Score ist nicht immer zuverlässig. Es ist immer noch nicht bewiesen, ob der Einsatz von Hybridklappen das Letalitätsrisiko senkt. Die spezifischen Komplikationsraten (Schlaganfall, AV-Block, paravalvuläres Leck) sind höher als nach konventioneller Operation.
Trotz des Enthusiasmus um die Hybridklappen erscheint es als sinnvoll, ihren Einsatz auf echte Konstellationen mit erhöhtem Risikoprofil zu beschränken.
Summary
The current enthusiasm with the development of catheter-based aortic valve replacement suggests a critical appraisal of the quality of conventional techniques.
Currently surgical treatment of diseased aortic valves includes different methods that can be employed with a low risk. Risk prediction is difficult, the Euroscore largely overestimates mortality.
By comparison, there is no evidence that the risk of implantation is reduced by catheter-based implantation. Specific complications (stroke, AV-block, perivalvular leak) are more frequent compared to conventional replacement.
Despite the current enthusiasm over the feasibility of catheter-based implantation of hybrid aortic valves they should still be used cautiously.
Schlüsselwörter
Aortenklappenvitium - Herzchirurgie - Qualitätssicherung - Herzklappenrekonstruktion - Herzklappenersatz
Keywords
aortic valve disease - cardiac surgery - quality management - aortic valve repair - aortic valve implantation
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Prof. Dr. Hans-Joachim Schäfers
Klinik für Thorax- und Herz-Gefäßchirurgie, Universitätsklinikum
des Saarlandes
Homburg/Saar
Phone: 06841/1632000
Fax: 06841/1632005
Email: h-j.schaefers@uks.eu