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Der Kardiologe

, Volume 11, Issue 5, pp 415–432 | Cite as

Passagere Herzunterstützungssysteme

  • D. L. StaudacherEmail author
  • P. M. Biever
  • D. Dürschmied
  • T. Wengenmayer
  • C. Bode
  • I. Ahrens
CME
  • 657 Downloads

Zusammenfassung

Als mechanische linksventrikuläre Unterstützungssysteme für Patienten mit konservativ nichtstabilisierbarer Herzinsuffizienz stehen die intraaortale Ballonpumpe (IABP), die Impella™-Pumpe, das TandemHeart™ und die extrakorporale Membranoxygenierung (ECMO) zur Verfügung. Aufgrund ihres Unterschieds in Aufbau und Wirkweise sind die spezifischen Indikationen und der individuelle potenzielle Nutzen für den Patienten zu berücksichtigen. Anhand der Haupteinsatzgebiete kardiogener Schock, prophylaktische Anlage bei kardialen Hochrisikoeingriffen und Reanimation ohne Wiedererlangen eines Spontankreislaufs werden die Systeme im Folgenden beleuchtet. Mechanische linksventrikuläre Unterstützungssysteme sind komplikationsbehaftet; sowohl akute als auch erst nach Explantation auftretende vaskuläre Komplikationen sind zu beachten. Diese sind dem potenziell lebensrettenden Nutzen gegenüberzustellen und können durch Expertise, Weiterentwicklung der Systeme und verbesserte Nachsorge reduziert werden.

Schlüsselwörter

Ventrikuläres Unterstützungssystem Extrakorporale Membranoxygenierung Kardiopulmonale Reanimation Schock, kardiogener Hochrisikoeingriff 

Passagere heart assist devices

Abstract

Several mechanical left ventricular assist devices are available for therapy of critically ill patients including the intra-aortic balloon pump (IABP), Impella™, TandemHeart™ and extracorporeal membrane oxygenation (ECMO). These percutaneous implantable devices have three main applications in cardiogenic shock, prophylactic implantation for high-risk interventions and implantation during cardiopulmonary resuscitation without return of spontaneous circulation. These devices, however, differ in construction and mechanism of action and therefore in the potential benefits for specific patients. Furthermore, vascular complications have to be taken into account, which can arise during implantation, operation as well as after explanation. Mechanical left ventricular assist devices are prone to complications, which are in contrast to the potentially life-saving benefits but might be reduced by expertise, improvement of the systems and improved aftercare.

Keywords

Ventricular assist device Extracorporeal membrane oxygenation Cardiopulmonary resuscitation Shock, cardiogenic High-risk interventions 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

D.L. Staudacher, P.M. Biever, D. Dürschmied, T. Wengenmayer, C. Bode und I. Ahrens geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • D. L. Staudacher
    • 1
    Email author
  • P. M. Biever
    • 1
  • D. Dürschmied
    • 1
  • T. Wengenmayer
    • 1
  • C. Bode
    • 1
  • I. Ahrens
    • 1
  1. 1.Klinik für Kardiologie und AngiologieUniversitäts-Herzzentrum Freiburg – Bad KrozingenBad KrozingenDeutschland

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