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Interventionelle Kinderkardiologie

Interventional pediatric cardiology

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Zusammenfassung

Perkutane Herzkatheterinterventionen haben sich neben den herzchirurgischen Verfahren zu einem wichtigen Eckpfeiler in der Behandlung angeborener Herzfehler etabliert. Sie kommen bereits im Neugeborenenalter zum Einsatz und können Operationen vor- und nachbereiten oder diese bei bestimmten Herzfehlern vollständig ersetzen. Herzkatheterinterventionen bei Kindern verteilen sich v. a. auf Verschlüsse intrakardialer Shunts, Ballondilatationen und Stent-Implantationen. Als neues Verfahren wurde in den letzten Jahren der perkutane Klappenersatz, v. a. im Bereich degenerierter Grafts in Pulmonalarterienposition, mit einer „stented valve“ sehr erfolgreich eingeführt. Spezielle Hybrideingriffe, die gemeinsam von Herzchirurg und Interventionist vorgenommen werden, z. B. in der Behandlung des hypoplastischen Linksherzsyndroms, erweitern das Spektrum zusätzlich. Die Zukunft wird zusätzlich neue schonendere, möglicherweise bioresorbierbare Materialien für Implantate und neue Implantationsverfahren bringen. Neben diesen spannenden Entwicklungen müssen jedoch auch die Langzeitergebnisse der aktuellen Behandlungsverfahren kritisch weiterverfolgt und die Interventionen ggf. angepasst werden.

Abstract

Percutaneous cardiac catheter interventions have become established as an important cornerstone in the treatment of congenital heart defects in addition to cardiac surgical procedures. They are even performed in newborns and can be used to prepare or to work-up operations and for certain cardiac defects they can even replace them completely. Cardiac catheter interventions in children mostly involve occlusions of intracardiac shunts, balloon dilatation and stent implantation. In recent years a new procedure, percutaneous valve replacement with a stented valve, was very successfully introduced in the treatment of degenerated grafts in pulmonary artery positions. Special hybrid interventions undertaken by cardiac surgeons together with interventionalists, e.g. in the treatment of hypoplastic left heart syndrome, have additionally extended the spectrum. The future will additionally bring a new milder, possibly bioresorbable material for implants and new implantation procedures. However, in addition to these exciting developments the long-term results of current treatment procedures must also be critically followed up and if necessary the interventions must be adapted.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. O. Kretschmar, S. Navarini, W. Knirsch geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Universitätskinderklinik Zürich, Steinwiesstr. 75, 8032, Zürich, Schweiz

    O. Kretschmar, S. Navarini & W. Knirsch

  2. Universitäts-Kinderspital Basel, Basel, Schweiz

    S. Navarini

Authors
  1. O. Kretschmar
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  2. S. Navarini
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  3. W. Knirsch
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Correspondence to O. Kretschmar.

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Kretschmar, O., Navarini, S. & Knirsch, W. Interventionelle Kinderkardiologie. Monatsschr Kinderheilkd 163, 69–83 (2015). https://doi.org/10.1007/s00112-014-3263-x

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  • DOI: https://doi.org/10.1007/s00112-014-3263-x

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