主动脉瓣的反流共25张课件

1、AORTIC REGURGITATIONAORTIC REGURGITATIONvocabularyperforation p3 fe rerr穿孔 ematurelyIpremetfe(r)过早的Anatomy e naetemigeometry d3i petri几何学,构成Aortic(ero. Ikprotracted pre traektro延长的senile si na老年性的orificeorts孔,洞,反流口Rheumaticumek风湿性 surrogatesNg代理、代表morphology m3: fled形态学 proximal proksImal,近端的commiss

2、ural disruption dIsrAp连合中断中断;分裂,瓦解;破裂,毁坏vocabularyAnatomy of the Aortic Valve and Etiologyof Aortic RegurgitationBased on the anatomy of the aortic valve, AR resultsfrom disease of either the aortic leaflets and/or theaortic root(Table 9)that results in valve malcoaptationAnatomy of the Aortic Valve

3、 anTable 9 Eticlogy and mechanisms of ARConcentaMleaflet abnormalitiesBicuspid, unicuspid, or quadricuspid aortic valveentricular septacquired leaflet abnormalitiesRheumatic diseaseRadi ation-induced valvulopathyToxin-inauced valvulopathy: anorectic drugs. 5-hy droxy tryptamine( carcinoid,Concenialc

4、enetic aorticAnnuloaortic ectasiaConnective tissue disease: Loeys Deitz, Ehlers-Danlos, Marfan syndrome, osteogenesis imperfe ctaAcquired aortic rootIdiopathic aortic root dilatationAutoimmune disease: systemic lupus erythematosis, ankylosing spondy itis, Reiters syndromeAortitis: syphilitic, Takaya

5、sus artentisAortic dissectionTraumaTable 9 Eticlogy and mechanismSuggested classification of AR morphologyAortic RegurgitationTypeNormal Cusp Motion with Aortic Dilation orCusp perforationType la depicts sinotubular junction enlargement and dilatation of the ascending aortaType Ib depicts dilatation

6、 of the sinuses of Valsalva and sinotubular junctionType Ic depicts dilatation of the annulus. Type ld denotes aortic cusp perforationSuggested classification of ARType ll is associated with excessiveleaflet motion from leaflet prolapse asa result of either excessive leaflettissue or commissural dis

7、ruptionType l is associated with restrictedleaflet motion seen with congenitallyabnormal valves, degenerativecalcification, or any other cause ofthickening/fibrosis or calcification ofthe valve leafletsType ll is associated with exc1. Echocardiographic ImagingIn severe acute AR the Lv is not dilated

8、 and the sudden rise inLV end-diastolic pressure may cause the MV to closeprematurelypremetfe(r)lI, best documented with an M-modeIn chronic AR, echocardiography is in tracking the changes inLV geometry d3i Dmetri(progessive increase in LV volume)and function (progressive worsening) due to the protr

9、actedpre traektrd LV volume overload1. Echocardiographic Imaging2. Doppler MethodsThe apical approach is the most sensitive for detectionthe parasternalpae . nl long and short axis areessential in evaluating II vaeljuerting) the origin of the jet2. Doppler MethodsColor flow DopplerBecause the length

10、 of the AR jet into the LV chamber is sodependent on the driving pressure(diastolic blood pressure), itis not a reliable parameter pa raemIte(o) of AR severitySIveretIIt is important to visualize vi3ue laIz the three componentsof the color jet (flow convergence, VC, and jet area for a betterassessme

11、nt of the origin and direction of the jet and its overallseverity(Figure 20)Color flow DopplerFCsUet heightFigure 20 Color flow Doppler of AR in the parasternal long-and short-axis viewsThe three components of the jet are shown with arrows: flow convergence(FC), vC,and Jet width in LVot in the Lv outflowFC主动脉瓣的反流共25张课件主动脉瓣的反流