Reshaping des linken Ventrikels – innovative Verfahren zur Herzinsuffizienztherapie?

Zusammenfassung

Linksventrikuläre Dilatation und Remodeling nach akutem Myokardinfarkt sind bekannt und mit einer Progression der Herzinsuffizienz und schlechter Prognose assoziiert. Chirurgische und interventionelle Therapieansätze zielen auf eine Wiederherstellung der linksventrikulären Form und Größe zur Verbesserung der linksventrikulären Funktion. Chirurgische Therapieoptionen beruhen auf einer direkten Ventrikulektomie. Neu entwickelte Hybridverfahren bieten weniger invasive Strategien an. Die kathetergestützte Implantation des Parachute® präsentiert sich als interventionelle Methode ohne operationsassoziierte Risiken mit ersten guten Kurzzeitergebnissen. Größere randomisierte Studien werden aktuell durchgeführt.

Abstract

Left ventricular dilatation and remodeling after myocardial infarction are associated with a progression of heart failure and poor prognosis. Surgical and interventional therapies aim to a restoration of left ventricular shape to improve left ventricular function. Surgical ventricular restoration leads to direct ventriculotomy. There are newly developed less invasive strategies using a hybrid approach between surgery and interventional cardiology to minimize the risk of operation. The Parachute® device works as a heart catheter based procedure without open heart surgery. First data are encouraging. There are ongoing randomized studies to confirm these data.

Schlüsselwörter

Herzinsuffizienz - ventrikuläres Remodeling - Parachute® - ventrikuläre Restauration

Key words

heart failure - ventricular remodeling - Parachute® - ventricular restoration

• Literatur

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