Herzchirurgie beim älteren Patienten

Zusammenfassung

Die Herzchirurgie bietet auch für Patienten im hohen Lebensalter exzellente Behandlungsergebnisse. Insbesondere die isolierte Bypassoperation und der Aortenklappenersatz stellen trotz des Vorhandenseins interventioneller Techniken immer noch den Goldstandard dar. Bei zunehmender Komplexität des Eingriffs müssen bei der Operationsplanung die biologischen Reserven der alten Patienten berücksichtigt werden. Die Etablierung eines Scoring-Systems für das geriatrische Syndrom, das einfach und kostengünstig in die klinische Routine übernommen werden kann, wäre eine große Hilfe bei der Entscheidungsfindung für die adäquate Therapie. Bei komplexeren Eingriffen sollten die Patienten für die Planung der optimalen Therapie einem aus Herzchirurgen und Kardiologen bestehenden Heart-Team vorgestellt werden.

Abstract

Cardiac surgery offers patients of advanced age excellent treatment results. In spite of a number of newer interventional techniques, isolated conventional bypass and aortic valve replacement in particular continue to represent the gold standard of treatment. With increasing complexity, the planning of surgical procedures must take the biological reserves of elderly patients into account. The establishment of a scoring system for geriatric syndrome which could be integrated simply and at low cost into clinical routine would greatly facilitate the therapeutic decision-making process. For more complex procedures, the task of devising an optimal therapeutic strategy should be in the hands of a heart-team comprising both cardiac surgeons and cardiologists.

Schlüsselwörter

Herzchirurgie - Bypassoperation - Alterschirurgie - Aortenklappenersatz - Mitralklappenersatz - geriatrisches Syndrom - Gebrechlichkeit

Key words

cardiac surgery - octogenarians - aortic valve replacement - mitral valve replacement - geriatric syndrome - frailty

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