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2020 | OriginalPaper | Buchkapitel

6. Ausgewählte Aspekte: Aortenklappe und Aortenwurzel

verfasst von : Olaf Stanger

Erschienen in: Kompendium der modernen Herzchirurgie beim Erwachsenen

Verlag: Springer Vienna

Zusammenfassung

Operationen an der Aortenklappe gehören zu den häufigsten Eingriffen in der Herzchirurgie und betreffen zumeist die degenerative Stenose (Aortenstenose, AST), seltener eine Insuffizienz oder auch das kombinierte Aortenvitium. Als Routineeingriff wird i. d. R. ein prothetischer Aortenklappenersatz (AKE) durchgeführt, bei einer Insuffizienz kommen auch zunehmend rekonstruktive Verfahren zur Anwendung. Dieses Kapitel verfolgt nun nicht die Absicht, dem Anfänger jeden Einzelschritt für die Implantation einer konventionellen gestenteten Klappenprothese zu illustrieren; denn damit sollte der Leser auf fachärztlichem Niveau bereits bestens vertraut sein und hierfür sind auch zahllose einschlägige Anleitungen und Lehrbuchbeiträge verfügbar. Jedoch ist das Management von Patienten mit einem Aortenvitium insgesamt anspruchsvoller geworden. Hatte noch vor Kurzem hauptsächlich das Patientenalter über eine mechanische oder biologische Klappenprothese mit Standardzugang entschieden, so sind nunmehr zahlreiche unterschiedliche Behandlungskonzepte verfügbar. Die optimale Wahl der Prothese, des chirurgischen Konzeptes und des Operationszeitpunktes erfordern oftmals individuelle Entscheidungen in den „Graubereichen“ der verfügbaren Guidelines. Hierfür soll dieses Kapitel einige nützliche Anregungen liefern.
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Metadaten
Titel
Ausgewählte Aspekte: Aortenklappe und Aortenwurzel
verfasst von
Olaf Stanger
Copyright-Jahr
2020
Verlag
Springer Vienna
DOI
https://doi.org/10.1007/978-3-7091-0451-4_6

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.