Indikation und Risiken der chirurgischen Behandlung von Aortenisthmusstenosen im Säuglingsalter

  • W. Ruschewski
  • B. Schorn
  • J. Gummert
  • D. Bartmus
Conference paper
Part of the Deutsche Gesellschaft für Chirurgie book series (DTGESCHIR, volume 1994)

Zusammenfassung

Die optimale Behandlung der Aortenisthmusstenose ist die großzügige chirurgische Resektion des erkrankten Gewebes und eine möglichst lange, schräge End-zu-End-Anastomose. Dies ist im Säuglingsalter bei hypoplastischem Aortenbogen bis in die Aorta ascendens möglich. Die Operationsletalität und Rezidiv-Stenoserate ist auch bei Operation im Neugeborenenalter so niedrig, daß auch bei asymptomatischen Patienten die Operation frühzeitig durchgeführt werden kann. Bei prästenotischer tubulärer Hypoplasie der Aorta descendens ist die Subclavia-Flap-Angioplastik mit der Arteria subclavia als mitwachsendes autologes Patchmaterial ein alternatives Operationsverfahren. Die Patchplastik mit prothetischem Material sollte wegen der Gefahr von Spätaneurysmen nicht mehr durchgeführt werden.

Schlüsselwörter

Aortenisthmusstenose Operation im Säuglingsalter Operationstechniken Langzeitergebnisse 

Surgical Correction of Aortic Coarctation in Infancy

Summary

The optimal treatment of coarctation is the complete resection of the abnormal tissue and an extended end-to-end anastomosis, in the neonate with hypoplasia of the transverse aortic arch as far as the ascending aorta. The operative mortality and rate of recoarctation is low. Therefore, early operation can be done even in asymptomatic infants without disadvantages. In cases of tubular hypoplasia of the descending aorta, subclavian flap angioplasty with the growth potential of the subclavian artery is an appropriate alternative technique, with the disadvantages of diminishing the blood supply to the left arm. Synthetic patch angioplasty cannot be recommended because of the high incidence of late aneurysm formation.

Key words

Aortic coarctation Operation in infancy Operative techniques Longterm results 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • W. Ruschewski
    • 1
  • B. Schorn
    • 1
  • J. Gummert
    • 1
  • D. Bartmus
    • 1
  1. 1.Klinik und Poliklinik für Thorax-, Herz- und GefäßchirurgieGeorg-August-UniversitätGöttingenDeutschland

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