Zusammenfassung
Mitralklappenerkrankungen stellen in Europa und anderen Industrienationen die zweithäufigste Herzklappenerkrankung dar. Therapie der Wahl bei der Mitralklappeninsuffizienz ist die Mitralklappenrekonstruktion. Seit den 1990er Jahren wurden Techniken zur minimal-invasiven Chirurgie entwickelt. Grundlagen dafür waren die Etablierung von Verfahren zum Anschluss der Herz-Lungen-Maschine über die Leistengefäße und die Methoden zur perkutanen, transthorakalen oder endoaortalen Aortenklemmung. Neben der videoassistierten Operation über eine rechtslaterale Minithorakotomie mit direkter Sicht ist auch ein total-endoskopisches und roboterassistiertes Verfahren möglich. Für die genannten Operationstechniken werden gleichsam exzellente Rekonstruktionsraten sowie Kurz- und Langzeitergebnisse in Bezug auf Mortalität und Morbidität beschrieben.
Abstract
Mitral valve disorders are the second most common heart valve disease in Europe and other industrialized nations. In mitral reconstruction the gold standard therapy is mitral valve repair. Minimally invasive techniques have been developed since the 1990s. As a first step techniques were introduced to establish a cardiopulmonary bypass through alternative access routes, namely the inguinal blood vessels. For aortic clamping two techniques are available: endoaortic balloon and transthoracic cross clamping. Besides video-assisted surgery by a right lateral minithoracotomy and direct vision, totally endoscopic and robot-assisted surgery is also available. For all techniques excellent operative results as well as good short and long-term outcomes have been described.
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Interessenkonflikt. S. Sündermann und V. Falk geben an, dass kein Interessenkonflikt besteht. Das vorliegende Manuskript enthält keine Studien an Menschen oder Tieren.
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Sündermann, S., Falk, V. Techniken der minimal-invasiven Mitralklappenchirurgie. Z Herz- Thorax- Gefäßchir 27, 399–410 (2013). https://doi.org/10.1007/s00398-013-1053-8
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DOI: https://doi.org/10.1007/s00398-013-1053-8