右室双出口英文课件.ppt

DoubleOutletRightVentricle(DORV),WEINI,1.withorwithouttranspositionofthegreatarteries2.ventricularseptaldefect(VSD)3.pulmonaryhypertensionorpulmonarystenosis(PHorPS),Whatiftherearedefects:,Definition,“DORVisatypeofcongenitalheartdiseasewhichbothgreatarteriesariseeitherentirelyorpredominantlyfromtherightventricle”,TheSocietyofThoracicSurgeons(STS)AndEuropeanAssociationforCardio-ThoracicSurgery(EACTS）-2000,spatialrelationshipofthesemilunarcuspsinheartswithDORV,.GreatArteriesRelationship,D-malposition（12%）,L-malposition（5%）,Parallel（29%）,NormalAN,AA,.LocationofVSD,Classificationoftheinterventricularcommunication/VSDaccordingtoitslocationinrelationtothegreatarteriessubaortic(65%)subpulmonary(20-25%)doublycommitted(3%)noncommitted(7%),Avastimportancetosurgicaloperation,ratherthananatonyorembryology,sizeinrelationtothediameteroftheaortadistancebetweenVSDandaorticvalve(overriding70%)presenceandseverityofasubpulmonaryobstruction,subaorticVSD,VSDbelowstheaorticvalveoverriding70%PHorPS,subaorticVSD,parasternallongaxis,Ao,Ao,LV,LA,RV,RV,Ao,PA,subaorticVSDwithseverepulmonarystenosis,subaorticVSD,PA,Ao,subpulmonaryVSD,sizeinrelationtothediameterofthepulmonaryarterypresenceandseverityofasubpulmonaryobstruction,VSDbelowsthepulmonaryvalveOverridingPHorPS,subpulmonaryVSD,RV,RV,PA,PA,doublyCommittedVSD,VSDbelowsboththeaortaandthepulmonaryarterypresenceandseverityofasubpulmonaryobstruction,non-committedVSD,VSDisinapositionawayfromthegreatarteriespresenceandseverityofasubpulmonaryobstructionsubcostalcoronal/4Cviews,LV,Ao,RV,LV,LV,RV,RV,AO,RV,AO,ThetypeofDORV,Accordingto:arterialinterrelationshipANAA(TGA)locationofVSDA-VSDN-VSDpulmonaryhypertensionorpulmonarystenosisPHPS,IANA-VSDPH,AO,RV,LV,PA,AO,IIANA-VSDPS,AO,AO,PS,AO,LA,LA,IIIANN-VSDPH,AO,PA,PA,IVANN-VSDPS,conalseptum,conalseptum,VAAA-VSDPH,VIAAA-VSDPS,PA,AO,VIIAAN-VSDPH,VIIIAAN-VSDPS,VIIIAAN-VSDPS,semilunarvalvesside-by-side(AN)DORVwithsubpulmonaryVSD(A-VSD)nosubpulmonaryobstruction(noPS)semilunarvalvesandAV-valvesseparatedbyconalseptum,Taussig-Bingmalformation(specialtype),Summary,1.morphologyandsizeofbothventriclesandAV-valves2.arterialinterrelationship3.LocationofVSDandthediameterofarteries4.locationandseverityofasubpulmonaryorsubaoticobstruction,Question,HowcanwedistinguishDORV(II)fromTOF?,DORV,TOF,DORV,DORV,DORV,DORV,DORV(II),Conalseptum,NextContent,1.physiopathology2.clinicalmanifestation3.surgic