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27.05.2020 | TAVI | Konsensuspapiere

Konsensuspapier der Deutschen Gesellschaft für Kardiologie (DGK) und der Deutschen Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie (DGTHG) zur kathetergestützten Aortenklappenimplantation (TAVI) 2020

verfasst von: Prof. Dr. Karl-Heinz Kuck, Sabine Bleiziffer, Holger Eggebrecht, Stephan Ensminger, Christian Frerker, Helge Möllmann, Holger Nef, Holger Thiele, Hendrik Treede, Gerhard Wimmer-Greinecker, Thomas Walther

Erschienen in: Die Kardiologie | Ausgabe 3/2020

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Zusammenfassung

Nach den 2 Positionspapieren der Deutschen Gesellschaft für Kardiologie (DGK) in 2015 und 2016 zum Thema der kathetergestützten Aortenklappenimplantation (TAVI) haben sich die DGK und die Deutsche Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie (DGTHG) entschlossen, ein Konsensuspapier vorzulegen, das die neuesten Ergebnisse von randomisierten und auch Beobachtungsstudien berücksichtigt, insbesondere bei Patienten mit hochgradiger Aortenklappenstenose (AS) und niedrigem operativem Risiko (STS-Score ≤4 %) sowie bei speziellen Indikationen wie „Klappe in Klappe“ und hochgradiger AS bei bikuspider Aortenklappe. Außerdem wird auf Komplikationen und Themen wie Haltbarkeit der perkutanen im Vergleich zu operativ eingesetzten Prothesen eingegangen – insbesondere unter dem Gesichtspunkt, dass Niedrigrisikopatienten jünger sind. Nach diesem Konsensuspapier wird ein chirurgischer Aortenklappenersatz (AKE) bei Niedrigrisikopatienten empfohlen, die ≤70 Jahre alt sind und keine anderen, in den üblichen Scores nicht enthaltenen Risikofaktoren aufweisen. TAVI wird empfohlen bei Patienten >75 Jahre und einer für TAVI geeigneten Anatomie nach Entscheidung im Herz-Team. Bei 70- bis 75-jährigen Patienten wird eine Herz-Team-Entscheidung zu TAVI oder AKE unter Bewertung der Lebensperspektive für den Patienten angesichts fehlender Langzeitdaten aus randomisierten Studien empfohlen. Unter Berücksichtigung des G‑BA(Gemeinsamer Bundesausschuss)-Beschlusses zur perkutanen Herzklappentherapie werden die Kriterien für die personellen und strukturellen Voraussetzungen unter dem Aspekt der Qualifikation des TAVI-Zentrums und des TAVI-Operateurs mit der speziellen Rolle des interventionellen Kardiologen und des Herzchirurgen definiert.

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Titel: Konsensuspapier der Deutschen Gesellschaft für Kardiologie (DGK) und der Deutschen Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie (DGTHG) zur kathetergestützten Aortenklappenimplantation (TAVI) 2020
verfasst von: Prof. Dr. Karl-Heinz Kuck
Sabine Bleiziffer
Holger Eggebrecht
Stephan Ensminger
Christian Frerker
Helge Möllmann
Holger Nef
Holger Thiele
Hendrik Treede
Gerhard Wimmer-Greinecker
Thomas Walther
Publikationsdatum: 27.05.2020
Verlag: Springer Medizin
Schlagwörter: TAVI
Aortenklappenersatz
Aortenklappenersatz
Aortenklappenstenose
Aortenklappenersatz
Erschienen in: Die Kardiologie / Ausgabe 3/2020
Print ISSN: 2731-7129
Elektronische ISSN: 2731-7137
DOI: https://doi.org/10.1007/s12181-020-00398-w

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