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Gefäßerkrankungen und -komplikationen im Rahmen von Herzoperationen

Vascular diseases and complications in cardiac surgery

  • Nachbardisziplinen
  • Published:
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Herzoperationen unterscheiden sich nicht nur aufgrund der Art und der Invasivität der Eingriffe, sondern auch aufgrund der Charakteristika des operierten Patientenkollektivs erheblich von anderen Arten der Chirurgie. Die zunehmende Prävalenz vaskulärer Begleiterkrankungen, ihrer potenziellen peri- und postoperativen Komplikationen sowie die zunehmende Alterung der Bevölkerung haben großen Einfluss auf das perioperative Management herzchirurgischer Patienten. Die gründliche prä- und perioperative gefäßmedizinische Bewertung und Untersuchung sind somit unerlässlich. Sie ermöglichen die Identifizierung der Patienten mit hohem Risiko für peri- und postoperative Komplikationen und somit die Entwicklung individueller Behandlungspläne, um Risiken zu minimieren. Die häufigsten perioperativen, extrakardialen Gefäßkomplikationen, die im Rahmen herkömmlicher Herzoperationen auftreten können, sowie deren Prävention und Behandlung werden im vorliegenden Beitrag behandelt.

Abstract

Cardiac surgery markedly differs from all other types of surgery in the preoperative cardiovascular evaluation as well as in potential perioperative and postoperative complications. An increasing prevalence of cardiovascular diseases, the related complications, as well as the increasing age of the population have a major impact on the contemporary perioperative management of cardiac surgery patients. Therefore, thorough preoperative and perioperative evaluation and diagnostics are essential which allows the identification of patients at high risk for perioperative and postoperative complications and to develop individual treatment plans to minimize these risks. The major perioperative, extracardiac vascular complications that can arise in conventional cardiac surgery and their prevention and treatment are described.

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Authors and Affiliations

  1. Abteilung für Angiologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48129, Münster, Deutschland

    F. Lüders & H. Reinecke

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  1. F. Lüders
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  2. H. Reinecke
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Correspondence to F. Lüders.

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Interessenkonflikt

F. Lüders und H. Reinecke geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Caption Electronic Supplementary Material

Video 1: Farbduplexsonographie einer A.-carotis interna-Stenose (Längsschnitt) (AVI 12mb).avi

Video 2: Farbduplexsonographie einer A.-carotis interna-Stenose (Querschnitt) (AVI 6.7mb)

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Video 3: Digitale Substraktionsangiographie einer A.-carotis-interna-Instent-Restenose sowie einer exulzerierten A.-carotis-externa-Stenose (AVI 2.7mb)

Video 4: Angiographie einer A.-poplitea-Stenose vor Katheterintervention (AVI 4.1mb)

Video 5: Balloninflation in der hochgradigen A.-poplitea-Stenose (AVI 29mb)

Video 6: Angiographie der A.-poplitea-Stenose nach Katheterintervention (AVI 3.9mb)

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Video 7: Angiographie einer A.-mesenterica-superior-Stenose bei okklusiver Mesenterialarterienischämie (vor Katheterintervention) (AVI 468kb)

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Video 8: Angiographie einer A.-mesenterica-superior-Stenose bei okklusiver Mesenterialarterienischämie (nach Stent-Implantation, Strahlengang von vorn) (AVI 1.7mb)

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Video 9: Angiographie einer A.-mesenterica-superior-Stenose bei okklusiver Mesenterialarterienischämie (nach Stent-Implantation, Strahlengang seitlich) (AVI 2.1mb)

Video 10: Duplexsonographie einer V.-poplitea-Thrombose mit pathologischem Kompressionstest (AVI 11mb)

Video 11: Farbduplexsonographie einer V.-poplitea-Thrombose mit pathologischem Kompressionstest (AVI 4.4mb)

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Video 12: unauffällige Duplexsonographie der V. femoralis communis mit normalem Kompressionstest beim selben Patienten (AVI 8.6mb)

Video 13: Angiographie bei ausgedehnter linksseitiger Lungenarteriembolie mit großen Thrombusmassen (AVI 3.8mb)

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Video 14: abschließende digitale Subtraktionsangiographie beim selben Patienten nach mehrfacher Thrombusfragmentation und -aspiration mit einem AngioJet®-System (AVI 1.1mb)

Video 15: zum Vergleich dazu unauffällige Pulmonalisangiographie bei einem anderen Patienten (AVI 1008kb)

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Lüders, F., Reinecke, H. Gefäßerkrankungen und -komplikationen im Rahmen von Herzoperationen. Z Herz- Thorax- Gefäßchir 29, 201–212 (2015). https://doi.org/10.1007/s00398-015-0006-9

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