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Ausgewählte Aspekte: Aortenklappe und Aortenwurzel

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Kompendium der modernen Herzchirurgie beim Erwachsenen

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Zusammenfassung

Operationen an der Aortenklappe gehören zu den häufigsten Eingriffen in der Herzchirurgie und betreffen zumeist die degenerative Stenose (Aortenstenose, AST), seltener eine Insuffizienz oder auch das kombinierte Aortenvitium. Als Routineeingriff wird i. d. R. ein prothetischer Aortenklappenersatz (AKE) durchgeführt, bei einer Insuffizienz kommen auch zunehmend rekonstruktive Verfahren zur Anwendung. Dieses Kapitel verfolgt nun nicht die Absicht, dem Anfänger jeden Einzelschritt für die Implantation einer konventionellen gestenteten Klappenprothese zu illustrieren; denn damit sollte der Leser auf fachärztlichem Niveau bereits bestens vertraut sein und hierfür sind auch zahllose einschlägige Anleitungen und Lehrbuchbeiträge verfügbar. Jedoch ist das Management von Patienten mit einem Aortenvitium insgesamt anspruchsvoller geworden. Hatte noch vor Kurzem hauptsächlich das Patientenalter über eine mechanische oder biologische Klappenprothese mit Standardzugang entschieden, so sind nunmehr zahlreiche unterschiedliche Behandlungskonzepte verfügbar. Die optimale Wahl der Prothese, des chirurgischen Konzeptes und des Operationszeitpunktes erfordern oftmals individuelle Entscheidungen in den „Graubereichen“ der verfügbaren Guidelines. Hierfür soll dieses Kapitel einige nützliche Anregungen liefern.

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    Olaf Stanger

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Stanger, O. (2020). Ausgewählte Aspekte: Aortenklappe und Aortenwurzel. In: Stanger, O. (eds) Kompendium der modernen Herzchirurgie beim Erwachsenen. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0451-4_6

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