Zusammenfassung
Parallel zu den Entwicklungen der Herzchirurgie eroberte sich die kathetergestützte, interventionelle Therapie eine wichtige Stellung bei der Behandlung von Kindern mit angeborenen Herzfehlern. Dabei sind einfache Vitien häufig interventionell kurativ behandelbar. Dies gilt insbesondere für den Vorhofseptumdefekt und den Ductus arteriosus. Beim Ventrikelseptumdefekt ist nur bei einer Minderheit der Betroffenen die Intervention möglich. Ballondilatationen der Pulmonal- und Aortenklappenstenosen hingegen haben einen festen Platz im interventionellen Repertoire. Stents – auch in beschichteter Form – ermöglichen eine wirksame Beseitigung von Gefäßstenosen und werden auch bei der Aortenisthmusstenose immer früher im Kindesalter erfolgreich eingesetzt. Die jüngste Einführung mit besonders hohem Stellenwert für die Behandlung angeborener Herzfehler ist der interventionelle Pulmonalklappenersatz. Die Hybridtherapie schließlich vereint Operation und Intervention in einem Eingriff, um die jeweiligen spezifischen Vorteile zu kombinieren.
Abstract
Transcatheter therapy has gained an important role in the treatment of children with congenital heart diseases. Simple defects like atrial septal defects and patent ducts can often be cured completely by catheter interventions, while only a minority of patients with ventricular septal defects can be treated. Balloon dilatations of the pulmonary and aortic valves are well accepted interventions. Stents, sometimes covered with a membrane, are very efficient for eliminating vessel stenoses and are also increasingly being implanted in younger children with aortic coarctation. The latest development with considerable impact on the treatment of congenital heart defects is the transcatheter pulmonary valve implantation. Finally, hybrid therapy joins surgical and transcatheter interventions in one single procedure to combine the specific advantages of the respective methods.
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Interessenkonflikt
Der korrespondierende Autor weist auf folgende Beziehungen hin: Berater für die Firmen AGA-Medical, CARAG-AG, Medtronic, Edwards Lifescience
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Ewert, P., Berger, F. Herzkatheterinterventionen bei angeborenen Herzfehlern. Monatsschr Kinderheilkd 158, 946–955 (2010). https://doi.org/10.1007/s00112-010-2178-4
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DOI: https://doi.org/10.1007/s00112-010-2178-4
Schlüsselwörter
- Angeborene Herzfehler
- Herzkatheterinterventionen
- Schirmchenverschluss
- Stenttherapie
- Interventioneller Pulmonalklappenersatz