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Echokardiographische Diagnostik bei interventioneller Mitralklappenrekonstruktion

Echocardiography in Interventional Mitral Valve Reconstruction

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Zusammenfassung

Die interventionelle Therapie der Mitralinsuffizienz ist seit jüngster Zeit in begrenztem Umfang möglich. Die entwickelten perkutanen Verfahren haben das Ziel, den Eingriff zu minimieren und damit insbesondere Hochrisikopatienten eine Therapie anbieten zu können. Der Echokardiographie kommt eine entscheidende Rolle bei der präinterventionellen Diagnostik, während der Prozedur und im postinterventionellen Verlauf zu. Präinterventionell ist neben der genauen Schweregradbestimmung der Mitralinsuffizienz insbesondere die Beurteilung der Klappenmorphologie wichtig. Darüber werden potentiell interventionell therapierbare Mitralinsuffizienzen wie auch das beste interventionell einzusetzende Therapieverfahren definiert. Während der interventionellen Therapie dient die Echokardiographie als entscheidendes Steuerungswerkzeug, das auch sofort den erreichten Therapieeffekt abschätzen lässt. Direkt postinterventionell sollte echokardiographisch ein Status erfasst werden, um eintretende Veränderungen der linksventrikulären Funktion wie auch der verbliebenen Mitralinsuffizienz im weiteren Verlauf vergleichend kontrollieren zu können.

Abstract

Interventional treatment of mitral insufficiency has recently become possible on a limited basis. The developed percutaneous procedures aim at minimizing the trauma in high-risk surgical candidates. Echocardiography has a major role in the preinterventional evaluation, during the interventional procedure, and in the postinterventional follow-up. The preinterventional analysis is focused on the assessment of valvular morphology and mitral insufficiency severity. This allows definition of patients potentially treatable by percutaneous therapy as well as the most suitable interventional approach. During interventional treatment, echocardiography is used as the integral tool to guide the procedure and for immediate assessment of the obtained therapeutic effect. Immediately post intervention, echocardiography should be performed to define the obtained status, allowing detection of subsequent changes in left ventricular function and mitral insufficiency severity.

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Authors and Affiliations

  1. Medizinische Klinik I, Universität Aachen, Aachen, Germany

    Rainer Hoffmann FESC & Ertunc Altiok

  2. European Cardiologist, Medizinische Klinik I, Universität Aachen, Pauwelsstraße, 52074, Aachen, Germany

    Rainer Hoffmann FESC

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  1. Rainer Hoffmann FESC
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  2. Ertunc Altiok
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Correspondence to Rainer Hoffmann FESC.

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Hoffmann, R., Altiok, E. Echokardiographische Diagnostik bei interventioneller Mitralklappenrekonstruktion. Herz 34, 426–434 (2009). https://doi.org/10.1007/s00059-009-3281-y

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  • DOI: https://doi.org/10.1007/s00059-009-3281-y

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