Skip to main content

Aortenklappenstenose

  • Living reference work entry
  • Latest version View entry history
  • First Online:
DGIM Innere Medizin

Part of the book series: Springer Reference Medizin ((SRM))

  • 667 Accesses

Zusammenfassung

Bei der Aortenstenose (Aortenklappenstenose) können erworbene und angeborene Formen unterschieden werden. Die vier Leitsymptome sind Dyspnoe, Angina pectoris, Schwindel und Synkopen sowie akute dekompensierte Herzinsuffizienz. Bei der Auskultation des Herzens ist ein rauhes, spindelförmiges systolisches Austreibungsgeräusch mit Fortleitung in die Karotiden zu hören. Mithilfe der Echokardiographie kann sowohl der transvalvuläre Gradient als auch die Aortenklappenöffnungsfläche zuverlässig bestimmt werden. Bei einem operationsbedürftigem Befund muss eine Herzkatheteruntersuchung einschließlich einer Koronarangiographie erfolgen. Solange die Aortenstenose asymptomatisch verläuft, ist eine operative Therapie nicht indiziert. Symptomatische Aortenstenosen müssen in der Regel operativ behandelt werden (Aortenklappenersatzoperation, TAVI-Klappe). Die begleitende Herzinsuffizienz wird medikamentös behandelt.

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

Access this chapter

Institutional subscriptions

Literatur

  • Bonow RO (2008) Bicuspid aortic valves and dilated aortas: a critical review of the ACC/AHA practice guidelines reco endations. Am J Cardiol 102(1):111–114

    Article  PubMed  Google Scholar 

  • Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS (2008a) 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 118(15):e523–e661

    Google Scholar 

  • Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS (2008b) Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 52(13):e1–e142

    Google Scholar 

  • Daniel WG, Baumgartner H, Gohlke-Barwolf C, Hanrath P, Horstkotte D, Koch KC, Mugge A, Schafers HJ, Flachskampf FA (2006) Aortic stenosis. Clin Res Cardiol 95(11):620–641

    Article  CAS  PubMed  Google Scholar 

  • Gilmanov D, Bevilacqua S, Mazzone A, Glauber M (2010) Do statins slow the process of calcification of aortic tissue valves? Interact Cardiovasc Thorac Surg 11(3):297–301

    Article  PubMed  Google Scholar 

  • Holmes DR Jr, Mack MJ, Kaul S, Agnihotri A, Alexander KP, Bailey SR, Calhoon JH, Carabello BA, Desai MY, Edwards FH, Francis GS, Gardner TJ, Kappetein AP, Linderbaum JA, Mukherjee C, Mukherjee D, Otto CM, Ruiz CE, Sacco RL, Smith D, Thomas JD (2012a) ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Am Coll Cardiol 59(13):1200–1254

    Google Scholar 

  • Holmes DR Jr, Mack MJ, Kaul S, Agnihotri A, Alexander KP, Bailey SR, Calhoon JH, Carabello BA, Desai MY, Edwards FH, Francis GS, Gardner TJ, Kappetein AP, Linderbaum JA, Mukherjee C, Mukherjee D, Otto CM, Ruiz CE, Sacco RL, Smith D, Thomas JD (2012b) ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement: developed in collaboration with the American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Failure Society of America, Mended Hearts, Society of Cardiovascular Anesthesiologists, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. Ann Thorac Surg 93(4):1340–1395

    Google Scholar 

  • Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, Fontana GP, Dewey TM, Thourani VH, Pichard AD, Fischbein M, Szeto WY, Lim S, Greason KL, Teirstein PS, Malaisrie SC, Douglas PS, Hahn RT, Whisenant B, Zajarias A, Wang D, Akin JJ, Anderson WN, Leon MB (2012) Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med 366(18):1686–1695

    Article  CAS  PubMed  Google Scholar 

  • Lesbre JP, Bertrand S, Tribouilloy C, Mertl C, Choquet D, Remond A (1990) Mid-term results of 50 percutaneous aortic valvuloplasties. Follow-up studies using Doppler echocardiography. Arch Mal Coeur Vaiss 83(2):183–190

    CAS  PubMed  Google Scholar 

  • Mohler ER, Gannon F, Reynolds C, Zimmerman R, Keane MG, Kaplan FS (2001) Bone formation and inflammation in cardiac valves. Circulation 103(11):1522–1528

    Article  PubMed  Google Scholar 

  • Natorska J, Bykowska K, Hlawaty M, Marek G, Sadowski J, Undas A (2011) Increased thrombin generation and platelet activation are associated with deficiency in high molecular weight multimers of von Willebrand factor in patients with moderate-to-severe aortic stenosis. Heart 97(24):2023–2028

    Article  CAS  PubMed  Google Scholar 

  • OBrien KD, Reichenbach DD, Marcovina SM, Kuusisto J, Alpers CE, Otto CM (1996) Apolipoproteins B, (a), and E accumulate in the morphologically early lesion of ‚degenerative‘ valvular aortic stenosis. Arterioscler Thromb Vasc Biol 16(4):523–532

    Google Scholar 

  • Otto CM, Pearlman AS, Gardner CL (1989) Hemodynamic progression of aortic stenosis in adults assessed by Doppler echocardiography. J Am Coll Cardiol 13(3):545–550

    Article  CAS  PubMed  Google Scholar 

  • Rosenhek R, Binder T, Porenta G, Lang I, Christ G, Schemper M, Maurer G, Baumgartner H (2000) Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med 343(9):611–617

    Article  CAS  PubMed  Google Scholar 

  • Rosenhek R, Klaar U, Schemper M, Scholten C, Heger M, Gabriel H, Binder T, Maurer G, Baumgartner H (2004) Mild and moderate aortic stenosis. Natural history and risk stratification by echocardiography. Eur Heart J 25(3):199–205

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Frank Weidemann .

Editor information

Editors and Affiliations

1 Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Invasive Ableitung des „Peak-to-peak“-Druckgradienten zwischen linken Ventrikel und der Aorta ascendens. Hierzu wird der Pigtail-Katheter unter kontinuierlicher Druckableitung vom linken Ventrikel in die Aorta zurückgezogen. (AO Aorta, LV linker Ventrikel) (AVI 8526 kb)

Fluoroskopie mit der Darstellung der Implantation einer TAVI-Klappe in die stenosierte Aortenklappe (AVI 19158 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Weidemann, F., Ertl, G. (2015). Aortenklappenstenose. In: Lehnert, H., et al. DGIM Innere Medizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_483-2

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-54676-1_483-2

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Online ISBN: 978-3-642-54676-1

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics

Chapter history

  1. Latest

    Aortenklappenstenose
    Published:
    07 June 2016

    DOI: https://doi.org/10.1007/978-3-642-54676-1_483-2

  2. Original

    Aortenklappenstenose
    Published:
    12 March 2015

    DOI: https://doi.org/10.1007/978-3-642-54676-1_483-1