主动脉瓣的反流共25张课件

AORTICREGURGITATIONAORTICREGURGITATION1vocabularyperforation[p3fererr穿孔ematurelyI'premetfe(r)过早的Anatomy[enaetemi]geometry[d3ipetri几何学,构成Aortic(er'o.Ikprotracted[[pretraektro]延长的senile[sina]老年性的orifice"orts]孔,洞,反流口Rheumatic[umek风湿性surrogate[sNg代理、代表morphology[m3:fled]形态学proximalproksImal,近端的commissuraldisruption[dIs'rAp连合中断中断;分裂,瓦解;破裂,毁坏vocabulary2AnatomyoftheAorticValveandEtiologyofAorticRegurgitationBasedontheanatomyoftheaorticvalve,ARresultsfromdiseaseofeithertheaorticleafletsand/ortheaorticroot(Table9)thatresultsinvalvemalcoaptationAnatomyoftheAorticValvean3Table9EticlogyandmechanismsofARConcentaMleafletabnormalitiesBicuspid,unicuspid,orquadricuspidaorticvalveentricularseptacquiredleafletabnormalitiesRheumaticdiseaseRadiation-inducedvalvulopathyToxin-inaucedvalvulopathy:anorecticdrugs.5-hydroxytryptamine(carcinoid,Concenial'ceneticaorticAnnuloaorticectasiaConnectivetissuedisease:LoeysDeitz,Ehlers-Danlos,Marfansyndrome,osteogenesisimperfectaAcquiredaorticrootIdiopathicaorticrootdilatationAutoimmunedisease:systemiclupuserythematosis,ankylosingspondyitis,ReiterssyndromeAortitis:syphilitic,Takayasu'sartentisAorticdissectionTraumaTable9Eticlogyandmechanism4SuggestedclassificationofARmorphologyAorticRegurgitationTypeNormalCuspMotionwithAorticDilationorCuspperforationTypeladepictssinotubularjunctionenlargementanddilatationoftheascendingaortaTypeIbdepictsdilatationofthesinusesofValsalvaandsinotubularjunctionTypeIcdepictsdilatationoftheannulus.TypelddenotesaorticcuspperforationSuggestedclassificationofAR5TypellisassociatedwithexcessiveleafletmotionfromleafletprolapseasaresultofeitherexcessiveleaflettissueorcommissuraldisruptionTypelisassociatedwithrestrictedleafletmotionseenwithcongenitallyabnormalvalves,degenerativecalcification,oranyothercauseofthickening/fibrosisorcalcificationofthevalveleafletsTypellisassociatedwithexc61.EchocardiographicImagingInsevereacuteARtheLvisnotdilatedandthesuddenriseinLVend-diastolicpressuremaycausetheMVtocloseprematurely['premetfe(r)lI,bestdocumentedwithanM-modeInchronicAR,echocardiographyisintrackingthechangesinLVgeometry[d3iDmetri](progessiveincreaseinLVvolume)andfunction(progressiveworsening)duetotheprotractedpretraektrdLVvolumeoverload1.EchocardiographicImaging72.DopplerMethodsTheapicalapproachisthemostsensitivefordetectiontheparasternal[pae'.nllongandshortaxisareessentialinevaluatingIIvaeljuerting)theoriginofthejet2.DopplerMethods8ColorflowDopplerBecausethelengthoftheARjetintotheLVchamberissodependentonthedrivingpressure(diastolicbloodpressure),itisnotareliableparameter[paraemIte(o)ofARseveritySI'veretIItisimportanttovisualizevi3uelaIz]thethreecomponentsofthecolorjet(flowconvergence,VC,andjetareaforabetterassessmentoftheoriginanddirectionofthejetanditsoverallseverity(Figure20)ColorflowDoppler9FCsUetheightFigure20ColorflowDopplerofARintheparasternallong-andshort-axisviewsThethreecomponentsofthejetareshownwitharrows:flowconvergence(FC),vC,andJetwidthinLVotintheLvoutflowFC10主动脉瓣的反流共25张课件11主动脉瓣的反流共25张课件12主动脉瓣的反流共25张课件13主动脉瓣的反流共25张课件14主动脉瓣的反流共25张课件15主动脉瓣的反流共25张课件16主动脉瓣的反流共25张课件17主动脉瓣的反流共25张课件18主动脉瓣的反流共25张课件19主动脉瓣的反流共25张课件20主动脉瓣的反流共25张课件21主动脉瓣的反流共25张课件22主动脉瓣的反流共25张课件23主动脉瓣的反流共25张课件24主动脉瓣的反流共25张课件25AORTICREGURGITATIONAORTICREGURGITATION26vocabularyperforation[p3fererr穿孔ematurelyI'premetfe(r)过早的Anatomy[enaetemi]geometry[d3ipetri几何学,构成Aortic(er'o.Ikprotracted[[pretraektro]延长的senile[sina]老年性的orifice"orts]孔,洞,反流口Rheumatic[umek风湿性surrogate[sNg代理、代表morphology[m3:fled]形态学proximalproksImal,近端的commissuraldisruption[dIs'rAp连合中断中断;分裂,瓦解;破裂,毁坏vocabulary27AnatomyoftheAorticValveandEtiologyofAorticRegurgitationBasedontheanatomyoftheaorticvalve,ARresultsfromdiseaseofeithertheaorticleafletsand/ortheaorticroot(Table9)thatresultsinvalvemalcoaptationAnatomyoftheAorticValvean28Table9EticlogyandmechanismsofARConcentaMleafletabnormalitiesBicuspid,unicuspid,orquadricuspidaorticvalveentricularseptacquiredleafletabnormalitiesRheumaticdiseaseRadiation-inducedvalvulopathyToxin-inaucedvalvulopathy:anorecticdrugs.5-hydroxytryptamine(carcinoid,Concenial'ceneticaorticAnnuloaorticectasiaConnectivetissuedisease:LoeysDeitz,Ehlers-Danlos,Marfansyndrome,osteogenesisimperfectaAcquiredaorticrootIdiopathicaorticrootdilatationAutoimmunedisease:systemiclupuserythematosis,ankylosingspondyitis,ReiterssyndromeAortitis:syphilitic,Takayasu'sartentisAorticdissectionTraumaTable9Eticlogyandmechanism29SuggestedclassificationofARmorphologyAorticRegurgitationTypeNormalCuspMotionwithAorticDilationorCuspperforationTypeladepictssinotubularjunctionenlargementanddilatationoftheascendingaortaTypeIbdepictsdilatationofthesinusesofValsalvaandsinotubularjunctionTypeIcdepictsdilatationoftheannulus.TypelddenotesaorticcuspperforationSuggestedclassificationofAR30TypellisassociatedwithexcessiveleafletmotionfromleafletprolapseasaresultofeitherexcessiveleaflettissueorcommissuraldisruptionTypelisassociatedwithrestrictedleafletmotionseenwithcongenitallyabnormalvalves,degenerativecalcification,oranyothercauseofthickening/fibrosisorcalcificationofthevalveleafletsTypellisassociatedwithexc311.EchocardiographicImagingInsevereacuteARtheLvisnotdilatedandthesuddenriseinLVend-diastolicpressuremaycausetheMVtocloseprematurely['premetfe(r)lI,bestdocumentedwithanM-modeInchronicAR,echocardiographyisintrackingthechangesinLVgeometry[d3iDmetri](progessiveincreaseinLVvolume)andfunction(progressiveworsening)duetotheprotractedpretraektrdLVvolumeoverload1.EchocardiographicImaging322.DopplerMethodsTheapicalapproachisthemostsensitivefordetectiontheparasternal[pae'.nllongandshortaxisareessentialinevaluatingIIvaeljuerting)theoriginofthejet2.DopplerMethods33ColorflowDopplerBecausethelengthoftheARjetintotheLVchamberissodependentonthedrivingpressure(diastolicbloodpressure),itisnotareliableparameter[paraemIte(