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Aorto-koronare Bypassoperation

  • Chapter
Koronarerkrankungen

Part of the book series: Handbuch der inneren Medizin ((INNEREN 9,volume 9 / 3))

Zusammenfassung

Der Weg zur aorto-koronaren Bypassoperation dauerte über ein halbes Jahrhundert. Meist wenig effektive Schritte in der chirurgischen Behandlung der Angina pectoris sind folgende (Zusammenfassung bei Schmuziger 1982):

  • Thorakale Grenzstrangresektion (Jonnesco 1920) Thyreoidektomie (Blumgart et al. 1935), Aufrauhen des Epi- und Perikard (Beck et al. 1948), Aufsteppen von Omentum majus auf das Herz (O’Shaugnessy 1936), Denervation des Herzens (Arnulf seit 1939), Ligatur des Sinus coronarius (Beck etal. 1948), A. mammaria interna Implantation in das Myokard (Vineberg seit 1950).

  • Die nach dem 2. Weltkrieg schnell fortschreitende Gefäßchirurgie sollte bald auch ihren Niederschlag in der Koronarchirurgie finden. Am 20. Oktober 1956 gelang Bailey die erste direkte Koronarrevaskularisation durch Endarteriektomie eines Circumflexa-Lateralastes, und noch im selben Jahr eine zweite Operation gleichen Charakters. Bei beiden Patienten wurde keine extrakorporale Zirkulation verwendet. Kurz nach Bailey führte auch Longmire ab 1957 mehrere ähnliche Operationen durch. Die Operationsletalität dieser partiell blinden Endarteriektomie erreichte fast 30%. Das Verfahren war technisch so anspruchsvoll, daß nur wenige Chirurgen sich dazu entschließen wollten. Eine Operationserleichterung konnte durch die Anwendung der extrakorporalen Zirkulation erzielt werden. Ebenso ließen sich die Resultate verbessern, indem die Arteriotomie mit einem venösen oder arteriellen Patch verschlossen wurde (Senning 1961).

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Authors
  1. H. Roskamm
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  2. K. Huesmann
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  3. M. Schmuziger
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Editor information

Editors and Affiliations

  1. Rehabilitationszentrum für Herz- und Kreislaufkranke Bad Krozingen, Südring 15, D-7812, Bad Krozingen, Germany

    Helmut Roskamm , P. Bubenheimer , C. Droste , A. Frey , L. Görnandt , H. Gohlke , Christa Gohlke-Bärwolf , P. Harnasch , K. Huesmann , D. Kalusche , W. Langosch , J. Petersen , B. Ritter , L. Samek , M. Schmuziger , K. Schnellbacher , P. Stürzenhofecker , A. Weisswange  & B. Wille , , , , , , , , , , , , , , , , ,  & 

  2. Lehrstuhl für Angewandte Physiologie der Universität, Hermann-Herder-Str. 7, D-7800, Freiburg, Germany

    E. Bassenge

  3. Medizinische Klinik I, Stadtkrankenhaus, Leimenstr. 20, D-6450, Hanau 1, Germany

    H.-J. Becker , W. A. Fach  & B. V. Mai ,  & 

  4. I. Medizinische Klinik B der Universität, Moorenstr. 5, D-4000, Düsseldorf, Germany

    G. Breithardt

  5. Abteilung Klinische Sozialmedizin, Klinikum der Universität, Bergheimerstr. 58, D-6900, Heidelberg 1, Germany

    L. Buchholz , W. Morgenstern , E. Nüssel  & R. Scheidt , ,  & 

  6. Strahlenklinik und Poliklinik, Abteilung für Radiologie mit Poliklinik, Universitätsklinikum Charlottenburg (FB 3), Spandauer Damm 130, D-1000, Berlin 19, Germany

    C. D. Claussen

  7. Abteilung Innere Medizin — Kardiologie, Universitätsklinikum Charlottenburg, Spandauer Damm 130, D-1000, Berlin 19, Germany

    H. Eichstädt

  8. Strahlenklinik und Poliklinik (WE 07), Abteilung Radiologie mit Poliklinik, Universitätsklinikum Charlottenburg, Spandauer Damm 130, D-1000, Berlin 19, Germany

    R. Felix  & D. Köhler  & 

  9. Kerckhoff-Klinik, Benekestr. 4-6, D-6350, Bad Nauheim, Germany

    M. Gottwik

  10. Emory University Hospital, Interventional Cardiovascular Medicine, Emory University School of Medicine, 1364 Clifton Road, 30322, N.E., Atlanta, Georgia, USA

    A. R. Gruentzig

  11. Cardiac Catheterization Laboratory, St. Louis University Medical Center, 1325 S. Grand Blvd., 63104, Mo., USA

    Th. Ischinger

  12. Zentrum der Inneren Medizin, Abteilung für Kardiologie, Klinikum der Universität, Theodor-Stern-Kai 7, D-6000, Frankfurt/Main 70, Germany

    M. Kaltenbach  & W. Schneider  & 

  13. Innere Abteilung der Kurklinik der LVA, D-6552, Bad Münster a. St. Ebernburg, Germany

    M. Keck

  14. Medizinische Poliklinik, Universität München, Pettenkoferstr. 8a, D-8000, München 2, Germany

    G. Lohmöller

  15. Innere Abteilung, Kreiskrankenhaus, Oßwaldstr. 1, D-8130, Starnberg, Germany

    H. Lydtin

  16. II. Medizinische Klinik, Abteilung Kardiologie, Universitäts-Krankenhaus Eppendorf, Martinistr. 52, D-2000, Hamburg 20, Germany

    D. G. Mathey

  17. Kardiologische Universitätsklinik, Allgemeines Krankenhaus der Stadt Wien, Garnisongasse 13, A-1097, Wien, Austria

    O. Pachinger  & H. Sochor  & 

  18. Pathologisches Institut, Städtische Krankenanstalten Mitte, Oelmühlenstr. 26, D-4800, Bielefeld 1, Germany

    R. Poche

  19. Röteweg 9, D-7800, Freiburg, Germany

    H. Reindell

  20. Max-Planck-Institut für Physiologische und Klinische Forschung, W.G. Kerckhoff-Institut, Parkstr. 1, D-6350, Bad Nauheim, Germany

    W. Schaper  & M. Siebes  & 

  21. I. Innere Abteilung, Krankenhaus Moabit, D-1000, Berlin 21, Germany

    K. P. Schüren

  22. Abteilung Innere Medizin III, Medizinische Klinik der Universität, Otfried-Müller-Straße, D-7400, Tübingen 1, Germany

    L. Seipel

  23. Departement Innere Medizin, Kantonsspital, Petersgraben 6, CH-4031, Basel, Switzerland

    E. Steinmann

  24. Pathologisches Institut, Städtische Krankenanstalten, Kulmbacher Str. 23, D-8580, Bayreuth, Germany

    M. Stolte

  25. Herz- und Gefäßchirurgische Abteilung, Rehabilitationszentrum für Herz- und Kreislaufkranke Bad Krozingen, Südring 15, D-7812, Bad Krozingen, Germany

    P. Tollenaere

  26. Internistisch-Kardiologische Abteilung, Theresienklinik, Brunnenallee 13, D-7812, Bad Krozingen, Germany

    H. Weidemann

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Roskamm, H., Huesmann, K., Schmuziger, M. (1984). Aorto-koronare Bypassoperation. In: Roskamm, H., et al. Koronarerkrankungen. Handbuch der inneren Medizin, vol 9 / 3. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69451-6_37

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  • DOI: https://doi.org/10.1007/978-3-642-69451-6_37

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