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  • 1 Gottsegen György Országos Kardiológiai Intézet Budapest Haller u. 29. 1096
  • 2 LKH-Univ. Klinik für Innere Medizin Klinische Abteilung für Kardiologie Graz Ausztria
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Panaszos aortabillentyű-szűkületben szenvedő betegek számára a billentyűcsere felbecsülhetetlen prognosztikai előnyt jelent. A thoracotomia, az aortotomia és a szívmotor alkalmazásából adódó morbiditás és mortalitás alternatív megoldások kereséséhez vezetett. A transzkatéteres endovascularis aortabillentyű-beültetéssel szerzett kezdeti tapasztalatok igazolták az eljárás megvalósíthatóságát és hatékonyságát, az akkori eszközökkel azonban a beavatkozás meglehetősen nehézkes volt. Időközben az eszközök és a beültetés technikája látványos fejlődésnek indultak, az operatőrök is egyre gyakorlottabbakká váltak. Megjelentek a ballonnal kinyitható és az önmaguktól kinyíló endoprotézisek, a perkután transfemoralis és a transapicalis megközelítés is megtalálni látszik a helyét előnyös és kedvezőtlen tulajdonságaiknak köszönhetően. A beavatkozás sikeraránya és klinikai kimenete folyamatosan javul. A közelmúltban zárult tanulmányok azt mutatják, hogy a magas kockázatú, idős betegeknél, a perkután módszer morbiditása és mortalitása a hagyományos sebészi technikáénál lényegesen kedvezőbb. Több mint egy év alapos előkészületeit követően, a Gottsegen György Országos Kardiológiai Intézetben 2008. november 11-én, Kelet-Közép-Európában először sikeres perkután aortabillentyű-beültetést végeztünk két idős, kritikus aortabillentyű-szűkületes betegnél. A betegek hétnapos kezelés után, nagyon jó általános állapotban hagyták el az intézetet.

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