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Erschienen in: Herz 5/2015

01.08.2015 | Schwerpunkt

Interventioneller Verschluss von Vorhofseptumdefekt, persistierendem Foramen ovale und Ventrikelseptumdefekt

verfasst von: Marius Hornung, Jennifer Franke, Dani Id, Prof. Dr. med. Horst Sievert

Erschienen in: Herz | Ausgabe 5/2015

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Zusammenfassung

Der interventionelle Verschluss kongenitaler Shunt-Vitien ist zu einem in der klinischen Routine etablierten Verfahren herangereift. So stellt der Katheterverschluss mittlerweile die Therapie der Wahl in der Behandlung des ASD dar. Er ist in fast allen Fällen der Defekte vom Sekundumtyp anatomisch möglich und mit einer Erfolgsrate von über 99 % technisch durchführbar. Der Eingriff kann in der Regel ohne Vollnarkose durchgeführt werden und erfordert nur einen kurzen Krankenhausaufenthalt. Das PFO ist eine potenzielle Durchtrittspforte für paradoxe Embolien. Diese können zu embolischen Schlaganfällen bzw. peripheren Embolien führen. Der Katheterverschluss hat im Vergleich zu einer lebenslangen Antikoagulation viele Vorteile und ist für manche Patienten die einzige therapeutische Option. Randomisierte Studien haben gezeigt, dass der interventionelle Verschluss zu Ergebnissen führt, die der medikamentösen Therapie vergleichbar sind. Bei einigen Okkludertypen gelang sogar der Nachweis signifikanter Vorteile gegenüber der medikamentösen Behandlung. Auch VSD einschließlich perimembranöser Defekte können in vielen Fällen kathetertechnisch verschlossen werden. Dies gilt sogar für VSD, die durch eine Ruptur des Septums infolge eines Myokardinfarkts entstanden sind.
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Metadaten
Titel
Interventioneller Verschluss von Vorhofseptumdefekt, persistierendem Foramen ovale und Ventrikelseptumdefekt
verfasst von
Marius Hornung
Jennifer Franke
Dani Id
Prof. Dr. med. Horst Sievert
Publikationsdatum
01.08.2015
Verlag
Urban & Vogel
Erschienen in
Herz / Ausgabe 5/2015
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-015-4331-2

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