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Erschienen in: Der Internist 4/2016

17.02.2016 | Echokardiografie | Schwerpunkt: Herzklappenerkrankungen

Paradoxe Low-flow-low-gradient-Aortenstenose

verfasst von: PD Dr. H. ten Freyhaus, Prof. Dr. S. Baldus

Erschienen in: Die Innere Medizin | Ausgabe 4/2016

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Zusammenfassung

Bei rund einem Drittel der Patienten mit mutmaßlich hochgradiger Aortenstenose besteht eine Diskrepanz zwischen einer hochgradig reduzierten Klappenöffnungsfläche (< 1 cm2) und einem nicht hochgradig erhöhten transvalvulären Gradienten (im Mittel < 40 mmHg). In einem signifikanten Teil dieser Fälle liegt eine paradoxe Low-flow-low-gradient-Aortenstenose vor, die durch ein reduziertes Schlagvolumen trotz normaler linksventrikulärer Ejektionsfraktion charakterisiert ist. Dann gilt es, Messfehler auszuschließen sowie den Grund für den hämodynamischen Befund zu identifizieren. Methodisch kommen v. a. die Echokardiographie, die Stressechokardiographie und die Computertomographie zum Einsatz. Sollte sich das Vorliegen einer hochgradigen paradoxen Low-flow-low-gradient-Aortenstenose beim normotensiven Patienten bestätigen, muss bei Vorliegen von vitiumassoziierten Beschwerden die Möglichkeit einer Klappenintervention evaluiert werden.
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Metadaten
Titel
Paradoxe Low-flow-low-gradient-Aortenstenose
verfasst von
PD Dr. H. ten Freyhaus
Prof. Dr. S. Baldus
Publikationsdatum
17.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Innere Medizin / Ausgabe 4/2016
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI
https://doi.org/10.1007/s00108-016-0027-9

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