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Anomalien der Aorta und ihre Bedeutung für den klinischen Alltag

Aortic anomalies and the importance in clinical routine

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Zusammenfassung

Die Inzidenz von Aortenanomalien beträgt bis zu 26%. Sie entstehen im Rahmen der Embryogenese durch eine konsekutive Reihe von sog. Migrationen, Fusionen und Atrophien der embryonalen primären Aortenanlage. Diese Fehlanlagen bzw. Varianten sind selten symptomatisch und werden meist im Rahmen der Schnittbildgebung diagnostiziert. Kenntnisse dieser Aortenanomalien sind für die offen-chirurgische, aber v. a. für die endovaskuläre Therapie (TEVAR) sinnvoll und notwendig. Die hier behandelten Pathologien beziehen in über 50% der Fälle den Aortenbogen mit ein. Der folgende Artikel gibt einen Überblick über die häufigsten Aortenanomalien, die für Gefäßchirurgen klinische Relevanz besitzen.

Abstract

The development of the human aorta is accomplished through a series of migrations, fusions, atrophies and hypertrophies of the primitive embryonal vasculature. Complex and multiple modifications from the primitive aorta finally result in the adult configuration and are the basis of congenital maldevelopment or anomalies in the great vessels. The incidence of variants and aortic malformations is as high as 26%. Dyspnea and dysphagia are potential leading symptoms from arch anomalies and hypertension syndrome from abdominal aortic coarctation but most patients remain asymptomatic. Knowledge of embryology and anatomy of the aorta is clinically important and not only for radiology, cardiology and heart surgery. Especially in endovascular therapy of aortic diseases, planning of surgical and endovascular procedures depends on anatomical considerations and morphology as more than 50% of thoracic aortic diseases involve the arch with its supraaortic branches. This manuscript gives an overview and insights on relevant aortic anomalies to clinicians and surgeons in the field of vascular medicine.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. D. Böckler und R. Kolvenbach geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Chirurgische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    D. Böckler

  2. Klinik für Gefäßchirurgie, Augusta-Krankenhaus Düsseldorf, Düsseldorf, Deutschland

    R. Kolvenbach

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  1. D. Böckler
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  2. R. Kolvenbach
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Correspondence to D. Böckler.

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Böckler, D., Kolvenbach, R. Anomalien der Aorta und ihre Bedeutung für den klinischen Alltag. Gefässchirurgie 18, 415–428 (2013). https://doi.org/10.1007/s00772-013-1191-z

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