Skip to main content
SpringerLink
Log in

Untersuchung der Klappenfunktion nach Mitralklappenrekonstruktion

  • Chapter
Book cover Die Echokardiographie im perioperativen und intensivmedizinischen Bereich

  • 2395 Accesses

Zusammenfassung

Mitralklappen-Erkrankungen zeichnen sich durch eine heterogene Genese, eine komplexe Anatomie und Funktion der Klappe sowie ihre Interaktion mit dem linken Ventrikel aus. Während eine medikamentöse Therapie das Krankheitsbild in seiner Progression zwar verlangsamen kann, hat nur die chirurgische Sanierung einen günstigen Effekt auf die Prognose. Aufgrund der komplexen (Patho-) physiologie des Klappenapparates weisen rekonstruktive chirurgische Verfahren einen deutlich besseren Effekt auf die Erhaltung der Funktionalität von Klappe und Ventrikel auf. Für eine genaue Diagnosestellung und Planung des chirurgischen Vorgehens hat die transösophageale Echokardiographie einen herausragenden Stellenwert erlangt. Sie verlangt aber vom Untersucher ein hohes Maß an Verständnis für die Anatomie und Funktion der Klappe und der zugrunde liegenden Pathologie sowie Kenntnis der einzelnen chirurgischen Techniken. Die transösophageale Echokardiographie ist für die genaue Diagnosestellung, die Quantifizierung des Vitiums, die gemeinsame Erarbeitung der Operationsstrategie mit dem Operateur und für die Überprüfung des chirurgis Ergebnisses die Methode der Wahl.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Spencer FC, Galloway AC, Grossi EA et al (1998) Recent developments and evolving techniques of mitral valve reconstruction. Ann Thorac Surg 65:307–313

    Article  PubMed  CAS  Google Scholar 

  2. Foot DK, Lewis RP, Pearson TA et al (2000) Demographics and cardiology, 1950–2050. J Am Coll Cardiol 35:1067–1081

    Article  PubMed  CAS  Google Scholar 

  3. Northrup WF (2005) Mitral valve repair: we must do a better job. Curr Cardiol Rep 7:391–397

    Google Scholar 

  4. Enriquez-Sarano M, Schaff HV, Frye RL (1999) Progression of mitral regurgitation. A prospective Doppler echocardiographic study. J Am Coll Cardiol 34:1137–1144

    Article  PubMed  CAS  Google Scholar 

  5. GrigionI F, Ennriquez-Sarano M, Ling LH et al (1999) Sudden death in mitral regurgitation due to flail leaflet. J Am Coll Cardiol 34:2078–2085

    Article  PubMed  CAS  Google Scholar 

  6. Averinos JF, Gersh BJ, Melton LJ 3rd et al (2002) Natural history of asymptomatic mitral valve prolapse in the community. Circulation 106:1355–1361

    Article  Google Scholar 

  7. Grigioni F, Averinos J, Ling LH et al (2002) Atrail fibrillation complicating the course of degenerative mitral regurgitation. Determinants and long-term outcome. J Am Coll Cardiol 40:84–92

    Article  PubMed  Google Scholar 

  8. Ling LH, Enriquez-Sarano M, Seward JB et al (1996) Clinical outcome of mitral regurgitation due to flail leaflet. N England J Med 335:1417–1423

    Article  CAS  Google Scholar 

  9. Ling LH, Enriquez-Sarano M, Seward JR et al (1997) Early surgery in patients with mitral regurgitation due to flail leaflets. Circulation 96:1819–1825

    PubMed  CAS  Google Scholar 

  10. Enriquez-Sarano M, Tajik AJ, Schaff HV et al (1994) Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications. J Am Coll Cardiol 24:1436–1543

    Article  Google Scholar 

  11. Dalrymple-Hay MJR, Bryant M, Jones RA et al (1997) Degenerative mitral regurgitation: when should we operate? Ann Thorac Surg 66:1579–1584

    Article  Google Scholar 

  12. Matsumura T, Ohtaki E, Tanaka K et al (2003) Echocardiographic prediction of left ventricular dysfunction after mitral valve repair for mitral regurgitation as anindicator to decide the optimal timing of repair. J Am Coll Cardiol 42:458–463

    Article  PubMed  Google Scholar 

  13. Tischler MD, Cooper KA, Rowen M et al (1994) Mitral valve replacement versus mitral valve repair. A Doppler and quantitative stress echocardiographic study. Circulation 89:132–137

    PubMed  CAS  Google Scholar 

  14. Grunkemeier GL, Wu Y (2003) “Our complication rates are lower than theirs”: statistical critique of heart valve comparisons. J Thorac Cardiovasc Surgery 125:290–300

    Article  Google Scholar 

  15. Grunkemeier GL, Li H-H, Naftel DC et al (2000) Long-term performance of heart valve prostheses. Curr Probl Cardiol 25:73–156

    Article  PubMed  CAS  Google Scholar 

  16. Rahimtoola SH (2003) Choice of prosthetic heart valve vor adult patients. J Am Coll Cardiol 41:893–904

    Article  PubMed  Google Scholar 

  17. Mohty D, Orszulak TA, Schaff HV et al (2001) Very long-term survival and durability of mitral valve repair for mitral valve prolapse. Circulation 104:(Suppl):I-1–I-7

    CAS  Google Scholar 

  18. Wilhelm MJ, Tavakoli R, Schneeberger K et al (2004) Surgical treatment of infective mitral valve endocarditis. J Heart Valve Dis 13:754–759

    PubMed  Google Scholar 

  19. Thourani VH, Weintraub WS, Guyton RA et al (2003) Outcomes and long-term survival for patients undergoing mitral valve repair versus replacement. Effect of Age and Concomitant Coronary Artery Bypass Grafting. Circulation 108:298

    Article  PubMed  Google Scholar 

  20. Reece TB, Tribble CG, Ellman PI et al (2004) Mitral repair is superior to replacement when associated with coronary artery disease. Ann Surg 239:671–675; discussion 675–677

    Article  PubMed  Google Scholar 

  21. Chaudhry FA, Upadya SP, Singh VP et al (2004) Identifying patients with degenerative mitral regurgitation for mitral valve repair and replacement: a transesophageal echocardiographic study. J Am Soc Echocardiogr 17:988–994

    Article  PubMed  Google Scholar 

  22. Spencer FC (1997) The development of valvular heart surgery over the past 50 years (1947–1997): Personal recollections. Ann Thorac Surg 64:1549–1554

    Article  PubMed  CAS  Google Scholar 

  23. Carpentier A, Deloche A, Dauptain J et al (1983) A new reconstructive operation for correction of mitral and tricuspid insufficiency. J Thorac Cardiovasc Surg 61:1–13

    Google Scholar 

  24. Carpentier A (1983) Cardiac valve surgery — the “French correction”. J Thorac Cardiovasc Surg 86:323–337

    PubMed  CAS  Google Scholar 

  25. Savage EB, Furguson TB Jr, DiSeva VJ (2003) Use of mitral valve repair: analysis of contemporary United States experience reported to the society of thoracic surgeons national cardiac database. Ann Thorac Surg 75:820–825

    Article  PubMed  Google Scholar 

  26. Gillinov AM, Cosgrove DM, Blackstone EU et al (1998) Durability of mitral valve repair for degenerative disease. J Thorac Cardiovasc Surg 116:734–743

    Article  PubMed  CAS  Google Scholar 

  27. Braunberger E, Deloche A, Berrebi A et al (2001) Very long-term results (more than 20 years) of valve repair with Carpentier’s techniques in nonrheumatic mitral valve insufficiency. Circulation 104(Suppl):I-8–I-11

    CAS  Google Scholar 

  28. Grossi EA, Galloway AC, Kallenbach K et al (1998) Early results of posterior leaflet folding plasty for mitral valve reconstruction. Ann Thorac Surg 65:1057–1059

    Article  PubMed  CAS  Google Scholar 

  29. Seitelberger R, Bialy J, Gottardi R et al (2004) Triangular plication of the anterior mitral leaflet: a new operative technique. Ann Thorac Surg 78:e36–37

    Article  PubMed  Google Scholar 

  30. Philips MR, Daly RC, Schaff HV et al (2000) Repair of anterior leaflet mitral valve prolapse: chordal replacement versus chordal shortening. Ann Thorac Surg 69:25–29

    Article  Google Scholar 

  31. Dreyfus GD, Bahrami T, Alayle N et al (2001) Reapair of anterior leaflet prolapse by papillary muscle repositioning: a new surgical option. Ann Thorac Surg 71:1464–1470

    Article  PubMed  CAS  Google Scholar 

  32. Fundarò P, Moneta A, Villa E et al (2001) Chordal plication and free edge remodeling for mitral anterior leaflet prolapse repair: 8-year follow-up

    Google Scholar 

  33. Smedira NG, Selman R, Cosgrove DM et al (1996) Repair of anterior leaflet prolapse: chordal transfer is superior to chordal shortening. J Thorac Cardiovasc Surg 112:287–292

    Article  PubMed  CAS  Google Scholar 

  34. Junjiro, K, Yoshikado S, Ko B et al (2000) Ten-year experience of chordal replacement with expanded Polytetrafluoroethylene in mitral valve repair. Circulation 102(Suppl):III-30–III-34

    Google Scholar 

  35. Maisano F, Schreuder JF, Oppizzi M et al (2000) The double-orifice technique as a standardized apporach to treat mitral regurgitation due to severe myxomatous disease: surgical technique. European Journal of Cardio-thoracic Surgery 17:201–205

    Article  PubMed  CAS  Google Scholar 

  36. Lorusso R, Borghetti V, Totaro P et al (2001) The double-orifice technique for mitral valve reconstruction: predictors of postoperative outcome. European Journal of Cardio-thoracic Surgery 20:583–589

    Article  PubMed  CAS  Google Scholar 

  37. Shanewise JS, Cheung AT, Aronson S et al (1999) ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American society of echocardiography council for intraoperative echocardiography and the society of cardiovascular anesthesiologists task force for certification in perioperative transesophageal echocardiography. Anesth Analg 89:870–884

    Article  PubMed  CAS  Google Scholar 

  38. Enriquez-Sarano M, Freeman WK, Tribouilloy CM et al (1999) Functional anatomy of mitral regurgitation. Accuracy and outcome implications of transesophageal echocardiography. J Am Coll Cardiol 34:1129–1136

    Article  PubMed  CAS  Google Scholar 

  39. Skarvan K, Bernet F (2005) Ischämische Mitralklappeninsuffizienz. Intensivmed 42:603–613

    Article  Google Scholar 

  40. Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA, Nihoyannopoulos P, Otto CM, Quinonen MA, Rakowski H, Stewart WJ, Waggoner A, Weissman NJ (2003) Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and doppler echocardiography (American Society of Echocardiography Report). J Am Soc Echocardiogr 16:777–802

    Article  PubMed  Google Scholar 

  41. Nakatani S, Masuyama T, Kodama K et al (1988) Value and limitations of Doppler echocardiography in the quantification of stenotic mitral valve area: comparison of the pressure half-time and continuity equation methods. Circulation 77:78–85

    PubMed  CAS  Google Scholar 

  42. Flachskampf FA, Weyman AE, Gillum L et al (1990) Aortic regurgitation shortens doppler presure half-time in mitral stenosis: clinical evidence, in vitro simulation, and theoretical analysis. J Am Coll Cardiol 16:396–404

    Article  PubMed  CAS  Google Scholar 

  43. Byrne JG, Aklog L, Adams DH (2000) Assessment and management of functional or ischaemic mitral regurgitation. The Lancet 355:1743–1744

    Article  CAS  Google Scholar 

  44. Poh KK, Hong EC, Yang H et al (2005) Transesophageal echocardiography during mitral valve repair underestimates mitral valve area by pressure half-time calculation. Int J Cardiol [Epub ahead of print]

    Google Scholar 

  45. Kinnaird TD, Munt BI, Ignaszewski AP et al (2003) Edge-to-edge repair for functional mitral regurgitation: an echocardiographic study of the hemodynamic consequences. J Heart Valve Dis 12:280–286

    PubMed  Google Scholar 

  46. Maslow AD, Regan MM, Haering JM et al (1999) Echocardiographic predictors of left ventricular outflow tract obstruction and systolic anterior motion of the mitral valve after mitral valve reconstruction for myxomatous valve disease. J Am Coll Cardiol 34:2096–2104

    Article  PubMed  CAS  Google Scholar 

  47. Tschernich H, Seitelberger R, Hiesmayr M (2005) Myokardinfarkt nach Mitralklappenrekonstruktion? Intensivmed 42:614

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinische Abteilung für Herz-, Thorax-, Gefäßanästhesie und Intensivmedizin, AKH Wien, Währingergürtel 18-20, 1090, Wien, Austria

    Dr. med. H. Tschernich & Univ.-Prof. Dr. M. Hiesmayr

  2. Klinische Abteilung für Herz- und Thoraxchirurgie Univ.-Klinik für Chirurgie, Medizinische Universitàt Wien, Wien

    Dr. R. Seitelberger

Authors
  1. Dr. med. H. Tschernich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dr. R. Seitelberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Univ.-Prof. Dr. M. Hiesmayr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. Tschernich .

Editor information

Editors and Affiliations

  1. Departement Anästhesie, Universitätsspital Basel, Spitalstr. 21, 4031, Basel

    Manfred D. Seeberger

  2. Ordinarius für Herz- und Thoraxchirurgie, Universitätsspital Basel, Spitalstr. 21, 4031, Basel

    Hans-Reinhard Zerkowski

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Steinkopff Verlag

About this chapter

Cite this chapter

Tschernich, H., Seitelberger, R., Hiesmayr, M. (2006). Untersuchung der Klappenfunktion nach Mitralklappenrekonstruktion. In: Seeberger, M.D., Zerkowski, HR. (eds) Die Echokardiographie im perioperativen und intensivmedizinischen Bereich. Steinkopff. https://doi.org/10.1007/978-3-7985-1608-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-7985-1608-3_8

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-1607-6

  • Online ISBN: 978-3-7985-1608-3

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation