Skip to main content
SpringerLink
Log in

Perioperative Komplikationen nach Herzklappenersatz

Perioperative complications after heart valve replacement

  • Published:
Zeitschrift für Kardiologie Aims and scope Submit manuscript

Summary

These days, the majority of perioperative complications resulting from operations on heart valves are more a consequence of the increasing age and morbidity of the patients and, despite all cardiac surgical and intensive care innovations, are still more the effect of the procedure on the other organ systems of the patient than being purely of a surgical nature. The surgical short — and long-term results after heart valve operations are significantly influenced by the early detection and adequate management of these manifold complications.

Zusammenfassung

Perioperative Komplikationen im Rahmen von Operationen an Herzklappen sind in der heutigen Zeit mehrheitlich nicht mehr rein chirurgischer Natur, sondern ein Resultat aus zunehmendem Alter und Morbidität der Patienten und den, trotz aller herzchirurgischen und intensivmedizinschen Innovationen, immer noch sehr gravierenden Auswirkungen des Eingriffs auf die Organsysteme des Patienten. Die chirurgischen Kurz- und Langzeitergebnisse nach Herzklappenoperationen werden ganz wesentlich durch das frühzeitige Erkennen und adäquate Management dieser vielgestaltigen Komplikationen beeinflusst.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Literatur

  1. Alarabi A, Nystrom SO, Stahle E, Wilkstrom B (1997) Acute renal failure and outcome of continous arteriovenous hemodialysis (LAVHD) and continous hemofiltration (CAVH) in elderly patients following cardiovascular surgery. Geriatr Nephrol Urol 7 (1): 45–9

    Article  CAS  PubMed  Google Scholar 

  2. Ali IM, Cummings B, Sullivan J, Francis S (1998) The risk of cerebrovascular accident in patients with asymptomatic critical carotid artery stenosis who undergo open-heart surgery. Can J Surg 41: 374–378

    CAS  PubMed  Google Scholar 

  3. Almassi GH, Schowalter T, Nicolosi AC, Aggarwal A, Moritz TE, Henderson WG, Tarazi R, Shroyer AL, Sethi GK, Grover FL, Hammermeister KE (1997) Atrial fibrillation after cardiac surgery: a major morbid event? Ann Surg 226: 501–513

    Article  CAS  PubMed  Google Scholar 

  4. Astor BC, Kaczmarek RG, Hefflin B, Daley WR (2000) Mortality after aortic valve replacement: results from a nationally representative database. Ann Thorac Surg 70: 1939–1945

    Article  CAS  PubMed  Google Scholar 

  5. Baskett RJ, MacDougall CE, Ross DB (1999) Is mediastinitis a preventable complication? A 10-year review. Ann Thorac Surg 67: 462–465

    Article  CAS  PubMed  Google Scholar 

  6. Birkmeyer NJ, Marrin CA, Morton JR, Leavitt BJ, Lahey SJ, Charlesworth DC, Hernandez F, Olmstead EM, O’Connor GT (2000) Decreasing mortality for aortic and mitral valve surgery in Northern New England. Northern New England Cardiovascular Disease Study Group. Ann Thorac Surg 70: 432–437

    Article  CAS  PubMed  Google Scholar 

  7. Blackstone EH, Kirklin JW (1985) Death and other time-related events after valve replacement. Circulation 72: 753

    Article  CAS  PubMed  Google Scholar 

  8. Borger MA, Rao V, Weisel RD, Ivanov J, Cohen G, Scully HE, David TE (1998) Deep sternal wound infection: risk factors and outcomes. Ann Thorac Surg 65: 1050–1056

    Article  CAS  PubMed  Google Scholar 

  9. Byrne JG, Hsin MK, Adams DH, Aklog L, Aranki SF, Couper GS, Rizzo RJ, Cohn LH (2000) Minimally invasive direct access heart valve surgery. J Cardiovasc Surg 15: 21–34

    CAS  Google Scholar 

  10. Carrier M, Pellerin M, Perrault LP, Page P, Hebert Y, Cartier R, Dyrda I, Pelletier LC (2001) Aortic valve replacement with mechanical and biologic prosthesis in middle-aged patients. Ann Thorac Surg [Suppl 5] 71: S253–S256

    Article  CAS  PubMed  Google Scholar 

  11. Chertow GM, Levy EM, Hammermeister KE, Grover F, Daley J (1998) Independent association between acute renal failure and mortality following cardiac surgery. Am J Med 104: 343–348

    Article  CAS  PubMed  Google Scholar 

  12. Daschner F (1997) Praktische Krankenhaushygiene und Umweltschutz, 2. Aufl. Springer, Berlin Heidelberg New York

    Book  Google Scholar 

  13. Ducceschi V, D’Andrea A, Galderisi M, De Feo M, Limongelli G, Mercurio B, Sarubbi B, Caso P, Cerasuolo F, Cotrufo M (2001) Risk predictors of paroxysmal atrial fibrillation following aortic valve replacement. Ital Heart J 2: 507–512

    CAS  PubMed  Google Scholar 

  14. Ennker J, Bauer S, Rosendahl U, Lehmann A, Mortasawi A, Schröder T, Alexander A, Ennker IC (1999) Simultaneous myocardial revascularization and aortiv valve replacement: stentless versus stented bioprostheses. Semin Thorac Cardiovasc Surg [Suppl 1] 11: 83–87

    CAS  PubMed  Google Scholar 

  15. Ennker J, Mortasawi A, Gehle S, Yaghmaie M, Schroder T, Rosendahl U, Ennker IC (2001) Aortic valve replacement with or without concomitant coronary artery bypass grafting in the ninth decade of life. Langenbecks Arch Surg 386: 272–277

    Article  CAS  PubMed  Google Scholar 

  16. Fernandez J, Laub GW, Adkins MS, Anderson WA, Chen C, Bailey BM, Nealon LM, McGrath LB (1994) Early and late-phase events after valve replacement with the St. Jude Medical prosthesis in 1200 patients. J Thorac Cardiovasc Surg 107: 394–407

    CAS  PubMed  Google Scholar 

  17. Genoni M, Franzen D, Vogt P, Seifert B, Jenni R, Kunzli A, Niederhauser U, Turina M (2000) Paravalvular leakage after mitral valve replacement: improved long-term survival with aggressive surgery? Eur J Cardiothorac Surg 17: 14–19

    Article  CAS  PubMed  Google Scholar 

  18. Genoni M, Franzen D, Tavakoli R, Seiffert B, Graves K, Jenni R, Turina M (2001) Does the morphology of mitral paravalvular leaks influence symptoms and hemolysis? J Heart Valve Dis 10: 426–430

    CAS  PubMed  Google Scholar 

  19. Grunenfelder J, on Segesser LK, Huynh-Do U, Binswanger U, Turina MI (1997) Is hemofiltration following acute kidney failure in elderly cardiovascular surgery patients justified? Schweiz Med Wochenschr 18; 127 (3): 53–9

    CAS  Google Scholar 

  20. Habicht JM, Scherr P, Zerkowski HR, Hoffmann A (2000) Late conduction defects following aortic valve replacement. J Heart Valve Dis 9: 629–632

    CAS  PubMed  Google Scholar 

  21. Jamieson WR, Edwards FH, Schwartz M, Bero JW, Clark RE, Grover FL (1999) Risk stratification for cardiac valve replacement. National Cardiac Surgery Database. Database Committee of the Society of Thoracic Surgeons. Ann Thorac Surg 67: 943–951

    Article  CAS  PubMed  Google Scholar 

  22. Kolh P, Kerzmann A, Lahaye L, Gerard P, Limet R (2001) Cardiac surgery in octogenarians. Peri-operative outcome and long-term results. Eur Heart J 22: 1235–1243

    Article  CAS  PubMed  Google Scholar 

  23. Kurusz M, Conti VR, Arens JF et al. (1986) Perfusion accident survey. Proc Am Acad Cardiovasc Perfusion 7: 57–64

    Google Scholar 

  24. Kvidal P, Bergstrom R, Horte LG, Stahle E (2000) Observed and relative survival after aortic valve replacement. J Am Coll Cardiol 35: 747–756

    Article  CAS  PubMed  Google Scholar 

  25. Llopart T, Lombardi R, Forselledo M, Andrade R (1997) Acute renal failure in open heart surgery. Ren Fail; 19 (2): 319–23

    Article  CAS  PubMed  Google Scholar 

  26. Lund O, Emmertsen K, Nielsen TT, Jensen FT, Flo C, Pilegaard HK, Rasmussen BS, Hansen OK, Kristensen LH (1997) Impact of size mismatch and left ventricular function on performance of the St. Jude disc valve after aortic valve replacement. Ann Thorac Surg 63: 1227–1234

    Article  CAS  PubMed  Google Scholar 

  27. Mangos GJ, Brown MA, Chan WY, Horton D, Trew P, Whitworth JA (1995) Acute renal failure following cardiac surgery: incidence, outcomes and risk factors. Aust N Z J Med; 25 (4): 284–9

    Article  CAS  PubMed  Google Scholar 

  28. Miller BE, Levy JH (1997) The inflammatory response to cardiopulmonary bypass. J Cardiothorac Vasc Anesth 11: 355–366

    Article  CAS  PubMed  Google Scholar 

  29. Miller DL, Morris JJ, Schaff HV, Mullany CJ, Nishimura RA, Orszulak TA (1995) Reoperation for aortic valve periprosthetic leakage: identification of patients at risk and results of operation. J Heart Valve Dis 4: 160–165

    CAS  PubMed  Google Scholar 

  30. Mortasawi A, Gehle S, Yaghmaie M, Schroder T, Ennker IC, Rosendahl U, Albert A, Ennker J (2001) Short and long term results of aortic valve replacement in patients 80 years of age and older. Herz 26: 140–148

    Article  CAS  PubMed  Google Scholar 

  31. Ohata T, Sawa Y, Kadoba K, Masai T, Ichikawa H, Matsuda H (1997) Effect of cardiopulmonary bypass under tepid temperature on inflammatory reactions. Ann Thorac Surg 64: 124–128

    Article  CAS  PubMed  Google Scholar 

  32. Overgaard CB, Harrison DA, Siu SC, Williams WG, Webb GD, Harris L (1999) Outcome of previous tricuspid valve operation and arrhythmias in adult patients with congenital heart disease. Ann Thorac Surg 68: 2158–2163

    Article  CAS  PubMed  Google Scholar 

  33. Perugini RA, Orr RK, Porter D, Dumas EM, Maini BS (1997) Gastrointestinal complications following cardiac surgery. An analysis of 1477 cardiac surgery patients. Arch Surg 132: 352–357

    Article  CAS  PubMed  Google Scholar 

  34. Peterseim DS, Cen YY, Cheruvu S, Landolfo K, Bashore TM, Lowe JE, Wolfe WG, Glower DD (1999) Long-term outcome after biologic versus mechanical aortic valve replacement in 841 patients. J Thorac Cardiovasc Surg 117: 890–897

    Article  CAS  PubMed  Google Scholar 

  35. Powell DE, Tunick PA, Rosenzweig BP, Freedberg RS, Katz ES, Applebaum RM, Perez JL, Kronzon I (2000) Aortic valve replacement in patients with aortic stenosis and severe left ventricular dysfunction. Arch Intern Med 160: 1337–1341

    Article  CAS  PubMed  Google Scholar 

  36. Schutz A, Eichinger W, Breuer M, Gansera B, Kemkes BM (1998) Acute mesenteric ischemia after open heart surgery. Angiology 49: 267–273

    Article  CAS  PubMed  Google Scholar 

  37. Shapira Y, Bairey O, Vatury M, Magen-Nativ H, Prokocimer M, Sagie A (2001) Erythropoietin can obviate the need for repeated heart valve replacement in highrisk patients with severe mechanical hemolytic anemia: case reports and literature review. J Heart Valve Dis 10: 431–435

    CAS  PubMed  Google Scholar 

  38. Soos J, Balogh I, Sotonyi P, Arvay A, Somogyi E (1975) Ultrastructural changes in the lungs induced by extracorporeal perfusion. Acta Morphol Acad Sci Hung 23: 239–246

    CAS  PubMed  Google Scholar 

  39. Stahle E, Tammelin A, Bergstrom R, Hambreus A, Nystrom SO, Hansson HE (1997) Sternal wound complications — incidence, microbiology and risk factors. Eur J Cardiothorac Surg 11: 1146–1153

    Article  CAS  PubMed  Google Scholar 

  40. Suen WS, Mok CK, Chiu SW, Cheung KL, Lee WT, Cheung D, Das SR, He GW (1998) Risk factors for development of acute renal failure (ARF) requiring dialysis in patients undergoing cardiac surgery. Angiology 49 (10): 789–800

    Article  CAS  PubMed  Google Scholar 

  41. Thourani VH, Weintraub WS, Craver JM, Jones EL, Mahoney EM, Guyton RA (2000) Ten-year trends in heart valve replacement operations. Ann Thorac Surg 70: 448–455

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Herzzentrum Lahr/Baden, Klinik für Herz-Thorax- und Gefäßchirurgie, Hohbergweg, 77933, Lahr, Germany

    Ulrich Rosendahl,  Ina Carolin Ennker,  Alexander Albert,  Stefan Bauer,  Amir Mortasawi,  Kerstin Bauer,  Fatmir Dalladaku,  Jochen Bories &  Jürgen Ennker

Authors
  1. Ulrich Rosendahl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ina Carolin Ennker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexander Albert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stefan Bauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amir Mortasawi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kerstin Bauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fatmir Dalladaku
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jochen Bories
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jürgen Ennker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ulrich Rosendahl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rosendahl, U., Ennker, I.C., Albert, A. et al. Perioperative Komplikationen nach Herzklappenersatz. Z Kardiol 90 (Suppl 6), 92–99 (2001). https://doi.org/10.1007/s003920170015

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s003920170015

Key words

Schlüsselwörter

Search

Navigation