Frühe Herzklappentherapie bei asymptomatischen Patienten – was gilt schon jetzt?

In general, a “watchful-waiting” strategy is the treatment strategy in patients with an asymptomatic high-grade aortic valve (AS) and normal left ventricular function. For patients with risk factors such as very severe AS, severe calcified AS, or 3-fold elevated proBNP level, aortic valve replacement may already be considered in the asymptomatic phase if the operative risk is low. Initial randomized trials indicate a benefit of early aortic valve replacement in asymptomatic patients with low operative risk.

In patients with asymptomatic high-grade aortic valve regurgitation, surgery should be considered early when signs of left ventricular damage are evident and the operative risk is low.

Apart from a close clinical and echocardiographic follow-up, asymptomatic patients with severe primary mitral regurgitation and normal left ventricular function and dimension, can be considered for surgical mitral valve repair, when performed at a Heart Valve Center and a durable repair is likely.

WAS IST WICHTIG?