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Kardiologie up2date 2007; 3(2): 111-121
DOI: 10.1055/s-2007-966526
Hotline - Kardiovaskuläre Notfälle

© Georg Thieme Verlag KG Stuttgart · New York

OAT- und TOSCA-2-Studie

Sollen nach Myokardinfarkt verschlossene Koronargefäße rekanalisiert werden, auch wenn das Zeitfenster zur Rettung von Herzmuskulatur überschritten ist?Wolfgang  Rutsch
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Publication Date:
06 July 2007 (online)

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Einführung

Der thrombotische Verschluss eines Koronargefäßes führt zeitabhängig zum Untergang von Myokard. Therapeutisches Ziel ist die frühzeitige Myokardreperfusion zur Begrenzung der Infarktgröße, Bewahrung der linksventrikulären Funktion und Verbesserung der Überlebenswahrscheinlichkeit. Patienten mit akutem Myokardinfarkt werden überwiegend mit systemischer Fibrinolyse versorgt.

Nach der akuten Behandlung eines Herzinfarktes sehen wir spät verschlossene Infarktgefäße nach

vergeblichen Therapiebemühungen, frustraner Fibrinolyse, erfolgloser PCI und bei Patienten, die gar keiner rekanalisierenden Behandlung unterzogen wurden.

Was kann Patienten nach erfolgloser Fibrinolyse angeboten werden? Ist Rescue-PCI die Therapie der Wahl oder eine zweite Fibrinolyse? Wie lange darf man nach Lyseeinleitung zuwarten, macht eine späte Rekanalisierung während der ersten 24 Stunden noch Sinn und sollten Infarktgefäße, die auch noch spät, d. h. jenseits der ersten 24 Stunden verschlossen sind, wiedereröffnet werden?

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Prof. Dr. med. Wolfgang Rutsch

Universitätsklinikum Charité, Campus Mitte
Medizinische Klinik und Poliklinik
Schwerpunkt Kardiologie & Angiologie

Charité-Platz 1
10117 Berlin

Email: wolfgang.rutsch@charite.de

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