Dokument: Eine einfache Formel zur Auswahl geeigneter Annuloplastieringe für die minimal-invasive Mitralklappenrekonstruktion
| Titel: | Eine einfache Formel zur Auswahl geeigneter Annuloplastieringe für die minimal-invasive Mitralklappenrekonstruktion | |||||||
| Weiterer Titel: | A simple formula to calculate the size of the suitable annuloplasty ring | |||||||
| URL für Lesezeichen: | https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=62187 | |||||||
| URN (NBN): | urn:nbn:de:hbz:061-20230322-111138-1 | |||||||
| Kollektion: | Dissertationen | |||||||
| Sprache: | Deutsch | |||||||
| Dokumententyp: | Wissenschaftliche Abschlussarbeiten » Dissertation | |||||||
| Medientyp: | Text | |||||||
| Autor: | Bountola, Chrysanthi [Autor] | |||||||
| Dateien: |
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| Beitragende: | Prof. Dr. med. Albert, Alexander [Gutachter] PD Sixt, Stephan Urs [Gutachter] | |||||||
| Stichwörter: | Mitralklappeninsuffizienz, Annuloplastie, Annuloplastiering | |||||||
| Dewey Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften » 610 Medizin und Gesundheit | |||||||
| Beschreibungen: | Die Mitralklappenrekonstruktion gewann in den letzten Jahren zunehmend an Bedeutung in der Mitralklappenchirurgie. Die Verwendung von Annuloplastieringen ist ein wichtiger Bestandteil der Mitralklappenrekonstruktion. Die Annuloplastie dient der Wiederherstellung der normalen systolischen Form und Größe des Mitralklappenannulus, welche eine wichtige Voraussetzung für eine optimale Segelkoaptation darstellt. Die Durchführung einer präoperativen Echokardiographie ist wichtig für die funktionelle Analyse der vorliegenden Pathologie und Anatomie der Mitralklappe sowie Planung der Mitralklappenrekonstruktion. Trotzdem gibt es keine einheitlichen Methoden zur Vermessung der Mitralklappe und Bestimmung der Größe sowie des Typus des Annuloplastieringes. Es gibt wenige Studien, in denen die verschiedenen Typen und Modelle der Annuloplastieringe verglichen wurden. Die Auswahl des Annuloplastieringes erfolgt auf Grundlange der vorliegenden Pathologie und nach persönlichen Erfahrungswerten der Herzchirurgen. Bei der vorliegenden Arbeit handelt sich um eine retrospektive Studie an 103 Patienten, die sich im Klinikum Dortmund im Zeitraum von 2018 bis 2021 einer Mitralklappenannuloplastie unterzogen haben. Im Rahmen dieser Studie erfolgte die Bestimmung der Länge des anterioren Mitralklappensegels (AML) im Segment 2, der Länge des posterioren Mitralklappensegels (PML) im Segment 2 und des interkommissuralen Abstandes in der uns vorliegenden echokardiographischen Datenbank. Diese einfachen echokardiographischen Parameter haben wir in Korrelation zur Größe des gewählten Annuloplastieringes gesetzt. Ziel dieses Vergleiches war eine einfache Formel zur erstellen, um die Größe des Annuloplastieringes aus den echokardiographischen Parametern errechnen zu können. Dies soll der standardisierten Anwendung chirurgischer Rekonstruktionstechniken dienen und für den individuellen Patienten die Haltbarkeit der Rekonstruktion optimieren sowie ein Wiederauftreten von Beschwerden und eine unnötige Re-Operation vermeiden.Mitral valve reconstruction has become increasingly important in mitral valve surgery in recent years. The use of annuloplasty rings is an important part of the mitral valve reconstruction. The annuloplasty ring is used to restore the normal systolic shape and size of the mitral valve annulus, which is an important prerequisite for optimal leaflet coaptation. Performing preoperative echocardiography is significant for the functional analysis of the present mitral valve pathology and anatomy, as well as for the planning of the mitral valve reconstruction. Nevertheless, there are no established methods for measuring the mitral valve and determining the size and type of the suitable annuloplasty ring. There are only a few studies that have compared the different types and models of annuloplasty rings. The annuloplasty ring selection is based on the present pathology and personal preferences of the cardiac surgeons. This is a retrospective study on 103 patients who underwent mitral valve annuloplasty at the cardiac surgery department in the Clinic of Dortmund between 2018 and 2021. For purposes of this study, we have analyzed echocardiographic parameters as regards the mitral valve with significant regurgitation from our database (the length of the anterior mitral valve leaflet (AML) in segment 2, the length of the posterior mitral valve leaflet (PML) in segment 2 and the intercommissural distance). Furthermore, we compared these simple echocardiographic parameters with the size of the chosen annuloplasty ring. The aim of this comparison was to create a simple formula to calculate the size of the suitable annuloplasty ring based on preoperative echocardiographic parameters. This should contribute to the standardized application of surgical reconstruction techniques and optimize the durability of the reconstruction for the individual patient and avoid recurrence of complaints and unnecessary reoperation. | |||||||
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| Rechtliche Vermerke: | Die Durchführung dieser Studie wurde von der Ethikkommission der Ärztekammer Westfalen-Lippe der Westfälischen Wilhelms-Universität genehmigt. Die Studiennummer lautet 2021-008-f-S. Ein Amendment-Votum in Bezug auf das Zeitfenster der Datenanalyse wurde von der Ethikkommission der Ärztekammer Westfalen-Lippe der Westfälischen Wilhelms-Universität am 01.08.2022 genehmigt. | |||||||
| Lizenz: |  Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz | |||||||
| Bezug: | 01.2021-03.2023 | |||||||
| Fachbereich / Einrichtung: | Medizinische Fakultät | |||||||
| Dokument erstellt am: | 22.03.2023 | |||||||
| Dateien geändert am: | 22.03.2023 | |||||||
| Promotionsantrag am: | 12.09.2022 | |||||||
| Datum der Promotion: | 07.03.2023 |
