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Mitralklappenstruktur und -funktion

Wie erfolgt die Auswahl für ein interventionelles oder chirurgisches Vorgehen?

Structure and function of the mitral valve

Eligibility criteria for surgical and interventional approaches

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Zusammenfassung

Mitralklappenerkrankungen, und hier vor allem schwere Mitralinsuffizienzen, nehmen in unserer Bevölkerung immer mehr zu. Betroffen sind häufig ältere Patienten mit zahlreichen Komorbiditäten, die aufgrund eines zu hohen perioperativen Risikos inoperabel sind. Da die Ergebnisse einer konservativen Therapie bei diesen Patienten oft unbefriedigend sind, konnten in den letzten Jahren interventionelle Techniken entwickelt werden, die auch bei diesen Patienten eine direkte Behandlung des Vitiums erlauben. Innovative Entwicklungen in der bildgebenden Diagnostik haben zu einem verbesserten diagnostischen und therapeutischen Management von Patienten mit Mitralklappenvitien geführt. Dies wirkt sich auf die Auswahl von Patienten für ein chirurgisches oder ein interventionelles Vorgehen gravierend aus. Dieser Review beschreibt die diagnostischen Möglichkeiten der Echokardiographie, anhand derer die Struktur und die Funktion der Mitralklappe für die Planung und die Durchführung eines chirurgischen oder eines interventionellen Vorgehens exakt beurteilt werden können.

Abstract

Mitral valve disease, especially severe mitral valve insufficiency, is an increasing issue in our population. Older patients with multiple comorbidities in particular are often denied surgery due to an increased perioperative risk. Because conservative medical treatment of mitral valve disease is often unsatisfactory, interventional techniques to treat mitral valve disease have emerged in recent years as serious alternatives to surgical treatment. Innovative developments in cardiovascular imaging have opened up new ways of looking at the mitral valve for improved diagnostic and therapeutic management of patients with mitral valve disease. These advantages of imaging are important for correct patient selection with either surgical or interventional strategies. This review describes the diagnostic capabilities of echocardiographic techniques for a precise diagnosis of the mitral valve structure and function for planning and performing interventional or surgical procedures.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Balzer und M. Kelm geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Abteilung für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    J. Balzer & M. Kelm

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Correspondence to J. Balzer.

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Balzer, J., Kelm, M. Mitralklappenstruktur und -funktion. Herz 40, 569–575 (2015). https://doi.org/10.1007/s00059-015-4234-2

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