Operative Mitralklappenrekonstruktion

ZUSAMMENFASSUNG

Die Mitralklappeninsuffizienz (MI) gehört neben der Aortenklappenstenose zu den häufigsten Klappenfehlern in den westlichen Ländern. Man unterscheidet je nach Pathologie zwischen der primären (degenerativen) und der sekundären (funktionellen) MI. Für die degenerative MI ist der therapeutische Goldstandard die chirurgisch-klappenerhaltende Korrektur des entsprechenden Klappenfehlers. Durch die Modernisierung der Herzchirurgie hat sich in den letzten Jahren zunehmend der Trend in Richtung minimal-invasiver Eingriffe gewandelt. Die in den letzten Jahren vorgestellten Methoden unterscheiden sich hauptsächlich im Zugangsweg. Der rechtsseitige anterolaterale Zugang ist aufgrund der guten Sicht auf die Mitralklappe inzwischen sowohl national als auch international als minimal-invasiver Zugang der Wahl etabliert. In wenigen spezialisierten Zentren wird darüber hinaus der videoassistierte total-endoskopische Zugangsweg mit exzellenten Ergebnissen angewendet.

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