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Der Klinikarzt 2020; 49(09): 382-387
DOI: 10.1055/a-1246-2857
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Operative Mitralklappenrekonstruktion

Immer endoskopisch?
Marwan Hamiko
1   Klinik und Poliklinik für Herzchirurgie, Universitätsklinikum Bonn
,
Hendrik Treede
1   Klinik und Poliklinik für Herzchirurgie, Universitätsklinikum Bonn
,
Hermann Reichenspurner
2   Klinik für Herz- und Gefäßchirurgie, Universitätsklinikum Hamburg-Eppendorf
› Author Affiliations
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Publication History

Publication Date:
19 September 2020 (online)

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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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