Strukturelle Herzerkrankungen – peri- und postinfarzielle Komplikationen

Zusammenfassung

Strukturelle Komplikationen stellen vergleichsweise seltene Komplikationen infolge akuter Myokardinfarkte dar, die aber mit einer sehr hohen Letalität einhergehen. Nachdem herzchirurgische Verfahren lange die einzige Therapieoption darstellten, werden nun zunehmend auch interventionelle Verfahren zur Behandlung struktureller Akutkomplikationen eingesetzt. Der Vorteil der Katheterverfahren liegt dabei vor allem in der geringeren Invasivität in der Behandlung der zumeist hämodynamisch instabilen Patienten, so z. B. in der Therapie der akuten Papillarmuskeldysfunktion oder des Infarkt-VSD. Darüber hinaus haben sich interventionelle Verfahren in der Behandlung der postinfarziellen funktionellen Mitralklappeninsuffizienz und der Volumenreduktion bei Aneurysmen des linken Ventrikels etabliert.

Abstract

Structural complications are rare complications following acute myocardial infarction, but they are associated with a very high mortality. Cardiac surgery was the only treatment option for patients with structural complications for decades. In the meantime a number of interventional techniques have been developed as a less invasive treatment option. The less invasiveness of the transcatheter techniques is of advantage especially in patients with acute hemodynamic instability, e.g. patients with an acute rupture of a papillary muscle or an acute ventricular septal defect. Furthermore, interventional cardiology could establish treatment options for chronic complications following myocardial infarction such as functional mitral regurgitation or the volume reduction of left ventricular aneurysms.

Schlüsselwörter

Ventrikelseptumdefekt - Mitralinsuffizienz - Aneurysma - Pseudoaneurysma - Herzinfarkt

Key words

ventricular septal defect - mitral regurgitation - aneurysm - pseudoaneurysm - myocardial infarction

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