Herz
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For symptomatic patients with severe aortic valve stenosis, open heart surgery for aortic valve replacement (AVR) with use of cardioplegia under cardiopulmonary bypass remains the gold standard. Cumulative surgical experience and technical improvement for more than 5 decades have led to excellent perioperative results with low mortality and morbidity. Long-term results are convincing, long-term survival is close to the average population, and durability of biological prostheses is favorable in the elderly. ⋯ Softening the indication for PAVI is ethically not acceptable yet. Randomized, prospective studies with long-term follow-up are mandatory to evaluate the valvular longevity and the consequences of system-immanent complications of PAVI compared to AVR. Selection of patients, conduction of the procedure and treatment of potentially life-threatening complications require a team of cardiac surgeons, interventional cardiologists and anesthesiologists with a fully equipped hybrid operating room including extracorporeal circulation.
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Review
[Left ventricular assist devices in chronic therapy of heart failure. Indication, results, risks].
Three generations of left ventricular assist devices are available for the therapy of heart failure. In the current development, pulsatile devices are being displaced by axial flow pumps. ⋯ In addition, by implanting a left ventricular assist device the quality of life was improved. Consequently, the importance of left ventricular assist devices in the therapy of heart failure is increasing.