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Mitralklappenersatz mit Erhalt des subvalvulären Apparats

Mitral valve replacement with preservation of the subvalvular apparatus

  • Operative Techniken
  • Published:
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Obwohl die Mitralklappenrekonstruktion das Verfahren der Wahl bei der chirurgischen Therapie der Mitralklappenerkrankungen, insbesondere der Mitralklappeninsuffizienz, darstellt, bleibt der prothetische Ersatz der Mitralklappe ein Routineverfahren in der Herzchirurgie. Nachdem in den Anfangsjahren des Mitralklappenersatzes noch eine Kontroverse hinsichtlich der Notwendigkeit, den Klappenapparat zu erhalten, bestand, ist heutzutage unstrittig, dass ein Ersatz der Mitralklappe unter partiellem oder vollständigem Erhalt des subvalvulären Halteapparats mit einer besseren Prognose vergesellschaftet ist. Ziel dieser Übersichtsarbeit ist es, grundlegende Techniken des Mitralklappenersatzes zu beschreiben und einen Einblick in die Bedeutung des subvalvulären Halteapparats für die Funktion des linken Ventrikels zu geben sowie verschiedene Verfahren zur Präservation des subvalvulären Apparats darzustellen.

Abstract

Despite the fact that mitral valve repair has become the most common approach in the treatment of mitral valve disease, particularly mitral regurgitation, prosthetic mitral valve replacement remains a standard procedure in cardiac surgery patients. After initial controversies regarding the importance of preservation of the subvalvular apparatus, it is today common sense that mitral valve replacement with partial or complete preservation of subvalvular structures is associated with an improved outcome. This article is intended to provide information about general techniques of mitral valve replacement, to describe the importance of the subvalvular structures for left ventricular function, and to discuss different approaches for the preservation of the subvalvular apparatus.

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  1. Klinik für Herz- und Thoraxchirurgie, Herzzentrum der Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland

    P.B. Rahmanian, J.T. Strauch & Th. Wahlers

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  1. P.B. Rahmanian
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  2. J.T. Strauch
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  3. Th. Wahlers
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Correspondence to P.B. Rahmanian.

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Rahmanian, P., Strauch, J. & Wahlers, T. Mitralklappenersatz mit Erhalt des subvalvulären Apparats. Z Herz- Thorax- Gefäßchir 24, 83–90 (2010). https://doi.org/10.1007/s00398-010-0770-5

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  • DOI: https://doi.org/10.1007/s00398-010-0770-5

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