Chirurgische Therapie der Herzinsuffizienz

Zusammenfassung

Patienten mit Herzinsuffizienz stellen eine besondere Herausforderung für den Herzchirurgen dar und erfordern u. a. aufgrund der großen Erfolge der medikamentösen Therapie einen interdisziplinären und individualisierten Therapieansatz. Grundsätzlich ergibt sich die Indikation für ein operatives Vorgehen aus symptomatischer und/oder prognostischer Sicht. Für die Therapie der Herzinsuffizienz ergeben sich folgende chirurgische Behandlungsoptionen. Eine Bypassoperation kann das Leben verlängern und die Symptome lindern. Ein Aortenklappenersatz kann bei hochgradigem Vitium das Leben verlängern und die Symptome lindern. Eine Mitralklappenoperation kann bei funktioneller Mitralklappeninsuffizienz die Symptome lindern. Eine Herztransplantation oder ventrikuläre Herz­unterstützungssysteme können die Symptome lindern und das Leben verlängern. Im Folgenden wird in kondensierter Form der aktuellen Stand der chirurgischen Therapiemöglichkeiten beschrieben.

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