Liakopoulos O J, Merkle J, Wahlers T, Choi Y-H
Klinik und Poliklinik für Herz- und Thoraxchirurgie, Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Herz. 2017 Sep;42(6):542-547. doi: 10.1007/s00059-017-4593-y.
Surgical aortic valve replacement still represents the gold standard in patients with severe symptomatic aortic valve stenosis. In addition to conventional aortic valve replacement by mechanical or biological prostheses via a median sternotomy, novel approaches including minimally invasive strategies and new devices, such as so-called rapid deployment prostheses, are becoming increasingly more established. Autologous replacement strategies including the Ross and the Ozaki procedures have evolved into reliable options at selected centers of excellence. These novel treatment approaches in aortic valve surgery result in excellent short and long-term outcomes with a reduction of procedure-related complications. Taken together, these modern surgical replacement strategies enable a personalized surgical treatment in patients with aortic valve stenosis, which are tailored to the individual patient.
对于有严重症状的主动脉瓣狭窄患者,外科主动脉瓣置换术仍是金标准。除了通过正中胸骨切开术使用机械或生物假体进行传统主动脉瓣置换外,包括微创策略和新装置(如所谓的快速部署假体)在内的新方法正越来越成熟。包括Ross手术和Ozaki手术在内的自体置换策略已在选定的卓越中心发展成为可靠的选择。这些主动脉瓣手术中的新治疗方法可带来出色的短期和长期效果,并减少与手术相关的并发症。总体而言,这些现代手术置换策略能够为主动脉瓣狭窄患者提供个性化的手术治疗,针对个体患者量身定制。