Patienten mit Klappenvitium auf der Intensivstation
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- 作者：Univ.-Doz. Dr. A. Geppert (1)
- 关键词：Kardiogener Schock ; Herzklappen ; Ballonvalvuloplastie ; Extrakorporale Membranoxygenierung ; Herzunterstzungssystem ; Cardiogenic shock ; Heart valves ; Baloon valvuloplasty ; Extracorporeal membrane oxygenation ; Heart assist devices
- 刊名：Medizinische Klinik
- 出版年：2013
- 出版时间：October 2013
- 年：2013
- 卷：108
- 期：7
- 页码：555-560
- 全文大小：
- 作者单位：Univ.-Doz. Dr. A. Geppert (1)
1. 3. Medizinische Abteilung mit Kardiologie, Wilhelminenspital der Stadt Wien, Montlearstr. 37, 1160, Wien, sterreich - ISSN：1615-6722
文摘
Valvular dysfunction is as frequent as acute coronary syndromes in the pathogenesis of acute decompensated heart failure. The prevalence of relevant valvular dysfunction increases with age and reaches more than 10% in patients over 75 years old. Guidelines and studies on the treatment of these patients, especially in an intensive care unit (ICU) setting are, however, scarce despite excellent guidelines for treatment of valvular heart disease in the general population. In the last decade a number of therapeutic alternatives became available when standard inotrope and vasopressor therapy fails to stabilize patients. These include balloon valvuloplasty in patients with severe aortic valve stenosis and assist devices, extracorporeal membrane oxygenation (ECMO) as well as mitral clipping. These therapeutic alternatives are to be considered as bridge to operation procedures in cases of shock due to valvular dysfunction, as hemodynamic stabilization and stabilization of organ function are essential to allow valve repair/replacement which is still considered to be the gold standard in this situation but is not always possible in the acute setting.