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Herztumoren und Perikarderkrankungen

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Kompendium der modernen Herzchirurgie beim Erwachsenen

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Zusammenfassung

In der ersten Hälfte des 20. Jahrhunderts wurden Herztumoren autoptisch diagnostiziert. 1954 erfolgte die erste chirurgische Entfernung eines Vorhofmyxoms durch Clarence Crafoord. Primäre Herztumoren sind selten – in einer großen Sammelstatistik über 731.309 Autopsien fand sich eine Inzidenz von 0,02 %. Die klinische Symptomatik von Herztumoren ist variabel und abhängig von Tumorlokalisation und Ausdehnung. Die Diagnosestellung gestaltet sich gelegentlich schwierig. Während früher schwere zerebrale oder periphere Embolien im Vordergrund standen und Patienten mit dekompensierter Herzinsuffizienz und mit erhöhter Operationsletalität gesehen wurden, zeigt der frühzeitige Einsatz der Echokardiographie auch als Screening-Methode einen deutlichen Wandel im klinischen Bild. Die meisten benignen Herztumoren stellen daher Zufallsbefunde dar. Allerdings sind die Patienten gefährdet, durch einen histologisch benignen Tumor am plötzlichen Herztod zu sterben, akut kardial zu dekompensieren und periphere Embolien zu erleiden. Da der natürliche Verlauf nicht vorhergesagt werden kann und die definitive Histologie erst durch die Operation geklärt werden kann, besteht prinzipiell immer eine Indikation zur Operation. Im Kindes- und Jugendalter kommen Rhabdomyome, Teratome oder Fibrome vor. Die Therapie der primären malignen Tumoren des Herzens und auch der sekundären Metastasen ist nach wie vor unbefriedigend.

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Authors and Affiliations

  1. Klinik für Herz- und Gefäßchirurgie, MediClin Herzzentrum Coswig, Coswig, Deutschland

    Torsten Bossert

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  1. Torsten Bossert
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Correspondence to Torsten Bossert .

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  1. Helios Klinikum München West, Klinik für Gefäßchirurgie Aortenzentrum Süd, München, Germany

    Olaf Stanger

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Bossert, T. (2020). Herztumoren und Perikarderkrankungen. In: Stanger, O. (eds) Kompendium der modernen Herzchirurgie beim Erwachsenen. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0451-4_13

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  • DOI: https://doi.org/10.1007/978-3-7091-0451-4_13

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  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0450-7

  • Online ISBN: 978-3-7091-0451-4

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