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Mitral valve regurgitation is one of the most important and frequent valve diseases in the western hemisphere. Primary mitral valve regurgitation is due to pathological alterations of the valve structure itself, whereas secondary mitral valve regurgitation is due to pathology of the left ventricle which ultimately leads to deterioration of mitral valve functioning and mitral regurgitation. The diagnostic pathway requires various cardiovascular examinations. Central diagnostic tool resembles echocardiography which provides besides visual impressions semi quantitative and quantitative parameters. Treatment options in patients with mitral valve regurgitation are based on interdisciplinary discussion between cardiologists and heart surgeons in the heart team. Besides the conservative treatment including medical and device heart failure therapy, surgical and interventional procedures are to be discussed in order to reduce mitral valve regurgitation. The decision making is greatly influenced by the nature of mitral valve regurgitation and by the concomitant comorbidities. © 2013 Springer-Verlag Berlin Heidelberg. Source


Kruska P.,Abt. fur Anasthesiologie und Operative Intensivmedizin | Spies C.,Charite - Medical University of Berlin | Debus E.S.,Universitares Herzzentrum Hamburg GmbH | Schwenk W.,Abt. fur Allgemein und Visceralchirurgie | And 2 more authors.
Gefasschirurgie | Year: 2010

The fast-track concept, a multidisciplinary approach to improve perioperative outcomes, has now been established in numerous surgical disciplines. Its application in vascular surgery has also been successfully demonstrated. The positive effects of fast-track rehabilitation can be achieved only by the cooperation of all professionals involved. Besides the surgeon, the anaesthesiologist plays a key role in perioperative management in fasttrack programmes through his or her direct influence on substantial aspects of the fasttrack concept. In this review, the authors describe therapeutic approaches of the anaesthesiologist using a fast-track concept in vascular surgery. © 2010 Springer-Verlag. Source


Nickenig G.,Universitatsklinikum Bonn | Mohr F.W.,University of Leipzig | Kelm M.,Universitatsklinikum Dusseldorf | Kuck K.-H.,II. Medizinische Abteilung | And 6 more authors.
Zeitschrift fur Herz-, Thorax- und Gefasschirurgie | Year: 2013

Mitral valve regurgitation is one of the most important and frequent valve diseases in the western hemisphere. Primary mitral valve regurgitation is due to pathological alterations of the valve structure itself, whereas secondary mitral valve regurgitation is due to pathology of the left ventricle which ultimately leads to deterioration of mitral valve functioning and mitral regurgitation. The diagnostic pathway requires various cardiovascular examinations. Central diagnostic tool resembles echocardiography which provides besides visual impressions semi quantitative and quantitative parameters. Treatment options in patients with mitral valve regurgitation are based on interdisciplinary discussion between cardiologists and heart surgeons in the heart team. Besides the conservative treatment including medical and device heart failure therapy, surgical and interventional procedures are to be discussed in order to reduce mitral valve regurgitation. The decision making is greatly influenced by the nature of mitral valve regurgitation and by the concomitant comorbidities. © 2013 Springer-Verlag Berlin Heidelberg. Source


Wild P.S.,Johannes Gutenberg University Mainz | Zeller T.,Universitares Herzzentrum Hamburg GmbH | Beutel M.,Universitatsmedizin Mainz | Blettner M.,Universitatsmedizin Mainz | And 5 more authors.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz | Year: 2012

The Gutenberg Health Study is a population-based, prospective, single-center cohort study that started in 2007 at the University Medical Center Mainz. The project focuses on cardiovascular diseases, cancer, eye diseases, metabolic diseases, diseases of the immune system and mental diseases. The study aims at improving the individual risk prediction for diseases. Therefore, lifestyle, psychosocial factors, environment, laboratory parameters as well as the extent of the subclinical disease are investigated. A comprehensive biobank enables biomolecular examinations including a systems biological approach. During the baseline visit 15,000 individuals aged 35-74 years were invited to a 5 h examination program in the study center. This will be followed by a computer-assisted telephone interview with a standardized interview and assessment of endpoints after 2.5 years. After 5 years a detailed follow-up examination comparable to the visit at study inclusion will be performed in the study center. Further follow-up visits of the cohort are envisaged. © Springer-Verlag 2012. Source


Behrendt C.-A.,Universitares Herzzentrum Hamburg GmbH | Tsilimparis N.,Universitares Herzzentrum Hamburg GmbH | Diener H.,Universitares Herzzentrum Hamburg GmbH | Larena-Avellaneda A.,Universitares Herzzentrum Hamburg GmbH | And 2 more authors.
Gefässchirurgie | Year: 2014

Increasing economic aspects of the healthcare system, forthcoming legislative amendments and an inhomogeneous patient population call for advanced methods of quality improvement and research in vascular medicine. More than 12 established international registry projects have proven the importance of clinical registries as a complementary method for randomized clinical trials (RCT). In the USA the restenosis rate after carotid endarterectomy (CEA) could also be decreased due to the results of register data. In the United Kingdom the mortality rate of elective surgery in 8380 patients with abdominal aortic aneurysms (AAA) has been reduced from 7,5 % to 2.4 % from 2008 to 2012 by the use of register data. Unlike in many other countries, Germany currently has no common population-based registry for vascular treatments. The prospective registry for AAA currently only records a small proportion of treatments. The mandatory data collection and analysis of approximately 33,000 CEAs by the AQUA Institute is an important part of quality insurance but has limitations because of the limited validity. An interdisciplinary common vascular registry for Germany, GermanVasc, allows a better and more accurate description of the actual medical care situation. With GermanVasc it will be possible to answer some of the key questions in vascular medicine in Germany. © 2014 Springer-Verlag Berlin Heidelberg. Source

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