Myokardrevaskularisation bei reduzierter linksventrikulärer Funktion

 

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Zusammenfassung

Die Myokardrevaskularisation bei hochgradig reduzierter linksventrikulärer Funktion stellt im klinischen Alltag eine besondere Herausforderung dar. Die hohe Sterblichkeit dieser Patienten konnte in den letzten Jahrzehnten im Wesentlichen durch die effektive Herzinsuffizienzmedikation gesenkt werden. Unzweifelhaft haben Revaskularisationsmaßnahmen bei ischämischer Genese einen hohen zusätzlichen Wert für die kardiovaskuläre Sterblichkeit und Morbidität der Patienten. Ob außerhalb von Akutsituationen eine Bypass-Operation oder eine perkutane Koronarintervention in Frage kommt, sollte anhand der Komorbiditäten des Patienten, der Koronarmorphologie und den Ergebnissen der Vitalitätstestung entschieden werden.

Abstract

Myocardial revascularization in patients with reduced left ventricular function remains a challenging clinical decision. The high mortality in these patients has been reduced by the routine use of guidelines-guided medical therapy for heart failure. However, myocardial revascularization additionally reduces cardiovascular mortality and improves functional outcome. Whether percutaneous coronary intervention or bypass surgery is indicated, should be decided individually with respect to comorbidities, morphology of the coronary vessels and the results of viability testing.

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