Aortenisthmusstenose – eine lebenslange Systemerkrankung

Zusammenfassung

Koarktation der Aorta (CoA) ist eine Systemerkrankung aller prästenotischen Arterien. Während im Säuglingsalter die chirurgische Behandlung im Vordergrund steht, werden erwachsene Patienten mit CoA oder Re-CoA nach chirurgischer Initialbehandlung, heute überwiegend mit Stents behandelt, wenn dies technisch möglich ist. Trotz erfolgreicher Beseitigung der aortalen Enge bleiben viele Patienten hypertensiv. Die Ursache des arteriellen Hypertonus ist multifaktoriell. Erwachsene CoA-Patienten müssen zum einen regelmäßig in einem EMAH-Zentrum evaluiert werden und benötigen zum anderen häufig eine permanente antihypertensive medikamentöse Therapie.

Abstract

Coarctation of the aorta is a systemic vessel disease of all prestenotic arteries. While newborns and infants with CoA are treated surgically, adults with CoA or Re-CoA after surgery are now treated with stent implantation, if that is technically feasible. Even though the stenosis can effectively be widened many CoA patients stay to be hypertensive. There are multiple reasons for this arterial hypertension. Adults with Coa/ReCoA need regular surveillance in a dedicated Adult Congenital Heart Disease Centre and often need lifelong antihypertensive medication.

Was ist wichtig?

• Die Behandlung einer Koarktation der Aorta (CoA/Re-CoA) im Erwachsenenalter erfolgt heute primär katheterinterventionell – wenn technisch möglich.

• Trotz Beseitigung eines Druckgradienten im Bereich des Aortenisthmus bleiben viele Patienten hypertensiv und müssen medikamentös behandelt werden.

• Altersabhängig steigt die Komplikationsrate der aortalen Stentings.

• Eine CoA ist eine chronische Erkrankung, die trotz aller Behandlungsoptionen gegenüber einem Normalkollektiv eine erhöhte Morbidität und Letalität aufweist und eine lebenslange serielle Nachbetreuung durch erfahrene, zertifizierte EMAH-Spezialisten erforderlich macht.

Schlüsselwörter

Aortenisthmusstenose - CoA - Koarktation der Aorta - Erwachsene mit angeborenem Herzfehler - Nachsorge - Systemerkrankung

Keywords

lifelong systemic disease - CoA - coarcation of the aorta - adult congenital heart disease - follow up

Publikationsverlauf

Artikel online veröffentlicht:
11. Oktober 2021

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