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Aortentherapie interdisziplinär: das A-Team

Interdisciplinary treatment of aortic diseases: the A-team

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Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Aufgrund verbesserter Notfallversorgung und progressiver angewandter Diagnostik wächst die Zahl an Patienten mit (meist symptomfreien) gesicherten pathologischen Aortenveränderungen stetig. Nicht selten überschreiten multisegmentale Aortenaneurysmata traditionelle „Fachgebietsgrenzen“; folglich ist die fachübergreifende Betreuung durch ein erfahrenes, interdisziplinäres Expertenteam zukunftweisend. Nur so kommen optimale, oft individuell „maßgeschneiderte“ – und mit internationalem „State of the Art“ abgeglichene – Therapiekonzepte zum Einsatz am Patienten. Sowohl die Kenntnis des chirurgischen und des interventionellen Goldstandards sowie auch neuester technischer Modifikationen und Verbesserungen von Stents und Prothesen gehören zu den Grundkenntnissen des Aortenexperten, die in diesem Gebiet, das einer enormen Entwicklung unterworfen ist, der ständigen Aktualisierung bedürfen. Da die Herz- und Gefäßchirurgie sowie die Angiologie sich immer weiter annähern, sollte die Therapie dieser Patienten mit komplexen Störungen gemeinsam im interdisziplinären Team diskutiert werden. Der vorliegende Beitrag bietet einen Überblick über aktuelle Behandlungsalgorithmen, chirurgische und interventionelle Therapieoptionen, einige etablierte deutsche Aortenzentren sowie Fort- und Weiterbildungsmöglichkeiten für den angehenden Aortenexperten.

Abstract

Due to improvements in emergency care and the progressive diagnostics applied, the number of patients with (mostly asymptomatic) confirmed pathological alterations of the aorta is continuously increasing. It is not uncommon for aortic aneurysms that extend over several segments to cross traditional borders between medical disciplines. This results in a trendsetting cross-sectoral care by an experienced interdisciplinary team of experts. This is the only way that optimal, often individually tailored and internationally comparable state of the art treatment concepts can be implemented for patients. Knowledge of the surgical and interventional gold standards as well as the most recent technical modifications and improvements in stents and prostheses are part of the fundamental knowledge of experts in the field of aortic diseases. This field is subject to an enormous development and continuous updating is necessary. As the treatment of patients with aortic diseases is complex and the demarcation between cardiac and vascular surgery as well as angiology is becoming less distinct, the treatment of these patients should be the subject of joint discussions in an interdisciplinary team. This article provides an overview on contemporary treatment algorithms, modern surgical and interventional treatment options, some established centers for aortic diseases in Germany as well as possibilities for training and advanced education to develop the specialists for aortic diseases needed in the future.

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Authors and Affiliations

  1. Universitätsklinik für Herzchirurgie, Herzzentrum Leipzig, Strümpellstr. 39, 04289, Leipzig, Deutschland

    J. Haunschild, K. von Aspern, M. A. Borger &  C. D. Etz

  2. Klinik und Poliklinik für Angiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    D. Scheinert & A. Schmidt

Authors
  1. J. Haunschild
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  2. K. von Aspern
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  3. D. Scheinert
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  4. A. Schmidt
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  5. M. A. Borger
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  6. C. D. Etz
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Correspondence to C. D. Etz.

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Interessenkonflikt

J. Haunschild, K. von Aspern, D. Scheinert, A. Schmidt, M.A. Borger und C.D. Etz geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Haunschild, J., von Aspern, K., Scheinert, D. et al. Aortentherapie interdisziplinär: das A-Team. Z Herz- Thorax- Gefäßchir 33, 446–453 (2019). https://doi.org/10.1007/s00398-019-00341-6

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