Pulmonalklappe

Zusammenfassung

Pulmonalklappenerkrankungen (PK-Erkrankungen) treten nach wie vor meist im Rahmen komplexer angeborener Herzfehler oder nach deren Korrektur auf, mit einer relevanten Zahl erworbener PK-Erkrankungen ist auch zukünftig nicht zu rechnen. Das Auftreten einer klinischen Beschwerdesymptomatik zeigt i. d. R. den medizinischen Handlungsbedarf an. Symptomatische PK-Fehler und hochgradige Vitien müssen meist zeitnah behandelt werden, zwecks Erhalt der myokardialen Funktion und der Lebensqualität/körperlichen Belastbarkeit des Patienten. Hier kommt der interventionellen Therapie eine führende Rolle zu, die Weiterentwicklung von Transkatheter-Herzklappen erlaubt die Versorgung auch komplexer anatomischer Veränderungen im rechtsventrikulären Ausflusstrakt (RVOT). Operative Verfahren hingegen behalten ihren Stellenwert in der Therapie kombinierter Vitien. Zukunftsperspektiven bietet das „tissue engineering“ durch mitwachsende Herzklappen.

Abstract

Pulmonary valve disease is a common finding in complex congenital heart disease, either native or after corrective surgery in childhood. In contrast, acquired pulmonic valve disease is rare and numbers will not increase in future. Symptom onset mostly indicates the need for therapy. Generally, symptomatic pulmonic valve disease and/or severe malformations require therapy, in order to preserve myocardial function and quality of life/exercise capacity of the patient. Meanwhile, interventional procedures gain profound impact, as further development of transcatheter heart valves offers a broad application even in complex anatomic RVOT morphologies. However, operative procedures maintain their role in the treatment of combined cardiac lesions. Future perspectives are offered by tissue engineering with self-growing human heart valves.

Schlüsselwörter

Fallot-Tetralogie - rechtsventrikulärer Ausflusstrakt - Ballonvalvuloplastie - perkutaner Pulmonalklappenersatz

Key words

tetralogy of Fallot - right ventricular outflow tract - balloon valvuloplasty - percutaneous pulmonary valve implantation

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