Zusammenfassung
Herzklappenerkrankungen sind neben der koronaren Herzerkrankung (KHK) die häufigsten Erkrankungen des Herz-Kreislauf-Systems. Nach der Aortenklappenstenose haben Erkrankungen der Mitral- und der Trikuspidalklappe hohe Inzidenzen. Die operative Sanierung ist heutzutage die Goldstandardtherapie. Perioperative und Langzeitergebnisse sind exzellent. Eine Verbesserung der Lebensqualität der Patienten kann in den meisten Fällen dauerhaft erzielt werden. Seit wenigen Jahren sind Therapieverfahren verfügbar, die bei Mitralklappeneingriffen eine Alternative für Hochrisikopatienten darstellen, da auf die Herz-Lungen-Maschine verzichtet werden kann. Die MitraClip®-Intervention zur Behandlung schwerer Mitralklappeninsuffizienzen (MI) zeigt ebenfalls gute Ergebnisse, jedoch fehlen Langzeitdaten. In diesem Beitrag werden die Evidenz und die Empfehlungen zur Behandlung erworbener Erkrankungen der Mitral- und Trikuspidalklappe (außer der Endokarditis) der aktuellen Guidelines zum Management von Herzklappenerkrankungen zusammengefasst. Die Guidelines wurden erstmalig gemeinsam von der European Society of Cardiology (ESC) und der European Association of Cardiothoracic Surgery (EACTS) erstellt. Im 1. Teil dieses Beitrags in einer vorherigen Ausgabe der Zeitschrift für Herz-, Thorax- und Gefäßchirurgie wurden die Empfehlungen zur Behandlung der Aortenklappenerkrankungen zusammengefasst.
Abstract
Heart valve disease is the most common disease of the cardiovascular system besides coronary heart disease. After aortic valve stenosis, mitral valve and tricuspid valve diseases also have a high incidence. Surgical intervention is currently the gold standard therapy. Perioperative and long-term results are excellent. An increase in the quality of life can be durably achieved for most patients. New therapies for high-risk patients are available that can be used to treat mitral valve disease without the use of a cardiopulmonary bypass. MitraClip procedures for the treatment of severe mitral valve insufficiency show good short-term results as well but comprehensive long-term results are lacking. This second part of the article summarizes the evidence and recommendations for the treatment of acquired diseases of mitral and tricuspid valves (except endocarditis) from the recent guidelines on the management of valvular heart disease which were published for the first time by the European Society of Cardiology (ESC) in conjunction with the European Association of Cardio-Thoracic Surgery. In the first part the recommendations for the treatment of aortic valve diseases were summarized.
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Interessenkonflikt. S. Sündermann und V. Falk geben an, dass kein Interessenkonflikt besteht. Das vorliegende Manuskript enthält keine Studien an Menschen oder Tieren.
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Sündermann, S., Falk, V. Zur Leitlinie Herzklappenerkrankungen der ESC und EACTS Version 2012. Z Herz- Thorax- Gefäßchir 28, 120–126 (2014). https://doi.org/10.1007/s00398-013-1033-z
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DOI: https://doi.org/10.1007/s00398-013-1033-z
Schlüsselwörter
- Erworbene Erkrankungen
- Evidenzbasierte Medizin
- Antikoagulation
- Herzklappenprothesenimplantation
- Herzklappenanuloplastie