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Ventrikuläre Langzeitunterstützung mit implantierbaren kontinuierlichen Flusspumpen

Auf dem Weg zum Goldstandard in der Therapie der terminalen Herzinsuffizienz

Ventricular long-term support with implantable continuous flow pumps

On the way to a gold standard in the therapy of terminal heart failure

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Zusammenfassung

Die mechanische Kreislaufunterstützung stellt heute eine wichtige Option in der Behandlung von Patienten mit fortgeschrittener Herzinsuffizienz dar. Einst als Überbrückung zur Herztransplantation entwickelt, ist sie heute eine wertvolle Möglichkeit der dauerhaften Unterstützung bei Patienten, bei denen einen Herztransplantation aufgrund von Kontraindikationen oder mangels Organverfügbarkeit ausscheidet. Darüber hinaus dient sie zur Überbrückung bis zur myokardialen Erholung und Explantation. Die Anzahl der Implantationen linksventrikulärer Unterstützungssysteme (LVAD) ist in den vergangenen Jahren deutlich angestiegen, und die Hälfte dieser Implantationen wird bereits heute in Nichttransplantationszentren durchgeführt. Diese Entwicklung macht es notwendig, dass jeder praktisch tätige Arzt mit den Grundprinzipien der mechanischen Kreislaufunterstützung und mit möglichen Komplikationen vertraut ist. Der vorliegende Artikel fasst den aktuellen Stand der Technik und Behandlung von Patienten mit ventrikulären Langzeitunterstützungssystemen zusammen.

Abstract

Mechanical circulatory support nowadays represents an important option in the treatment of patients with advanced heart insufficiency. Once developed as a bridging to heart transplantation, it is now a valuable option for permanent support in patients for whom a heart transplantation is not possible due to contraindications or a lack of available organs. Furthermore, it can be used as a bridging to myocardial recovery and explantation. The number of implantations of left ventricular assist devices (LVAD) has clearly increased in recent years and approximately one half of these implantations is already carried out in centers not specialized in transplantations. This development necessitates that every practicing physician is aware of the basic principles of mechanical circulatory support and with the possible complications. This article gives a summary of the current state of the technology and treatment of patients with long-term VADs.

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Notes

  1. Die International Society for Heart and Lung Transplantation hat Richtlinien für die Behandlung von Patienten mit mechanischen Kreislaufunterstützungssystemen [22] herausgegeben. Die Empfehlungen in diesem Abschnitt basieren auf dieser Richtlinie.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Krabatsch, E. Potapov, S. Soltani, M. Dandel, V. Falk und C. Knosalla geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    T. Krabatsch, E. Potapov, S. Soltani, M. Dandel, V. Falk & C. Knosalla

  2. Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK) – Standort Berlin, Berlin, Deutschland

    T. Krabatsch, E. Potapov, M. Dandel, V. Falk & C. Knosalla

Authors
  1. T. Krabatsch
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  2. E. Potapov
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  3. S. Soltani
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  4. M. Dandel
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  5. V. Falk
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  6. C. Knosalla
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Correspondence to T. Krabatsch.

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Krabatsch, T., Potapov, E., Soltani, S. et al. Ventrikuläre Langzeitunterstützung mit implantierbaren kontinuierlichen Flusspumpen. Herz 40, 231–239 (2015). https://doi.org/10.1007/s00059-015-4209-3

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