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lüll Heart valve surgery today: indications, operative technique, and selected aspects of postoperative care in acquired valvular heart disease Geissler HJ; Schlensak C; Sudkamp M; Beyersdorf FDtsch Arztebl Int 2009[Mar]; 106 (13): 224-33; quiz 234BACKGROUND: Surgery plays a central role in the management of acquired valvular heart disease. The optimal diagnostic evaluation, surgical treatment, and postoperative care of these patients are only possible through a cooperative effort of the primary care physician, the cardiologist, and the cardiac surgeon. METHODS: The literature was selectively searched for information on surgical indications, operative techniques, and postoperative care in acquired valvular heart disease. Evidence-based guidelines and treatment recommendations were also taken into account. RESULTS: A wide variety of techniques and implants are now available for the surgical treatment of acquired valvular heart disease. If they are used in evidence-based fashion, the perioperative mortality is low and the long-term outcome is favorable. CONCLUSIONS: The volume of surgery for acquired valvular heart disease in Germany has increased substantially in recent years, from 25,495 cases in 2002 (corresponding to 26.5% of all heart operations in that year) to 33,412 in 2007 (36.5% of all heart operations). The causes for this include both demographic changes and the availability of new, less invasive surgical techniques that yield better results in elderly and/or multimorbid patients. Because of these new techniques, the indications for surgery have widened, while the results have remained favorable.|*Heart Valve Prosthesis[MESH]|Germany/epidemiology[MESH]|Heart Valve Diseases/*mortality/*surgery[MESH]|Heart Valve Prosthesis Implantation/*methods/*mortality[MESH]|Humans[MESH]|Incidence[MESH]|Postoperative Care/*statistics & numerical data[MESH] |