心脏外科学讲义英文版课件

心脏外科学讲义英文版HeartSurgery心脏外科学讲义英文版CHDPAbloodincreasePAblooddecreaseOtherabnormalitiesofconotruncusOtherabnomalies心脏外科学讲义英文版PAbloodincreaseBloodshutfromleftheartsystemtorightatatrial,ventricularorgreatarterylevelPDAASDVSDAVcanaldefect心脏外科学讲义英文版PDA-PatentductusateriosusroleofductusarteriosusLocationRecurrentlaryngealnerveFailtocloseafter3months

心脏外科学讲义英文版Funnel心脏外科学讲义英文版PhysiologyofPDAL–RshuntPAbloodincreaseLVvolumeoverloadComplication:aneurism,IE,calcification,pulmonaryvasculardiseasePAhypertensionLVenlargement心脏外科学讲义英文版DiagnosisofPDABodysign:continous‘machinery’murmurSBP-DBPincreaseLVenlargeElectriccardiographyEchocardiographyX-rayCardiaccatheterization

心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版TreatmentofPDAClosureOfPDALigationCutAndsultureCPBandpatchclosureTranscutaneouscatheterclosure心脏外科学讲义英文版心脏外科学讲义英文版ComplicationofPDAligationBleedingRecurrentlaryngealnerveinjuryAneurismReopenReflectivehighbloodpressureother心脏外科学讲义英文版ASDPremum–partialatrialventricularcanaldefectSecundem–ostiumSVCIVCmixedCS心脏外科学讲义英文版心脏外科学讲义英文版PathophysiologyofASDL-RshuntingPulmonaryhypertensionPvasculardisEisenmengersyndrome心脏外科学讲义英文版DisgnosisofASDPhysicalexam:SM,P2Subtlesignofheartfailure:exercise,palpitation,arrhythmiasEchoCGElectricCGcatheterization心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版treatmentPFO:80%spontaneousclosurein1st.closurefor:symppomaticpatientssignificantASDL-Rshuntover1.5:1Closureway:surgpercutaneoustranscatheterdevicetransthoraciccatheterdevicetransthoracicscopeassisted

心脏外科学讲义英文版VSDPerimembranousMuscularSubarterialAtrioventricular心脏外科学讲义英文版心脏外科学讲义英文版PathophysiologyofVSDL-RshuntingPbloodincreaseLVvolumeoverloadPHEisenmengersyndrome心脏外科学讲义英文版DisgnosisofVSDPhysicalexam:SM,P2Subtlesignofheartfailure:exerciseintolerance,palpitation,arrhythmiasEchoCGElectricCGcatheterization心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版TreatmentSpontanousclsoureclosurefor:symppomaticpatientslargeVSDClosureway:surgpercutaneoustranscatheterdevicetransthoraciccatheterdevicetransthoracicscopeassisted心脏外科学讲义英文版心脏外科学讲义英文版SurgforVSDHeartincisionPatchComplication心脏外科学讲义英文版TOFVSDAorticoveridingRVOTORVhypertrophycombinedabnormalities心脏外科学讲义英文版心脏外科学讲义英文版DisgnosisofTOFClinical:symptoms(cyanosis,anoxiaspell,exerciseintolerance,squat)bodysign(dysplasia,cyanosis,pestlelokefinger,heartcheck)X-ray:bootshapeEchoCGElectricCGcatheterization心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版RescueforTOFspellKnee-to-chestOxygenSedation:morphineVolumeexpansionIncreasecardiacpreloadandsystemicresistance心脏外科学讲义英文版SurgeryforTOFTwostage:classicandmodifiedblalock-taussingshuntSinglestage:VSDclosure+RVOTOrelief心脏外科学讲义英文版心脏外科学讲义英文版心脏外科学讲义英文版ValveDiseaseCongenitalRheumaticDegenerativeInfectionImmune心脏外科学讲义英文版Mitralvalvestenosis心脏外科学讲义英文版MSValvularlesionsfreeedgeechointensity,thickening,valvularadhesion,openingareaisreduced：

minor：1.5—2.0cm2moderate：1.0－1.5cm2

severe：<1.0cm2心脏外科学讲义英文版Ppv↑WholeheartfailureMSPGa-v↑PHRV↑LA↑RVfailure

LVfailure心脏外科学讲义英文版ClinicalManifestationsSymptoms

(1)Dyspnea:Theearliestsymptoms;

(2)hemoptysis,bloodysputum;

(3)cough;

(4)hoarseness;(Signs

(1)mitralvalveface.

(2)signsofheartmitralstenosis;①apexbeatisnotobvious;②S1loud;③DM.

(3)pulmonaryhypertensionandrightventriculardilatation心脏外科学讲义英文版EchoNMs心脏外科学讲义英文版NMs心脏外科学讲义英文版Aorticstenosis（AS）EtiologyCongenital:Congenitalhypoplasiaoftheaorticvalve,twolobesormultiplelobes;subvavularlocatedstenosis;Acquired:rheumaticorseniledegeneration心脏外科学讲义英文版PathologyandhemodynamicchangesAnaorticvalveitselfincreasedpressureloadASLVHLHFIncreaseinmyocardialoxygenconsumption

IntracardiacdiastolicpressureCoronaryperfusionMyocardialischemia心脏外科学讲义英文版ClinicalInfestationSymptoms:Dyspnea,angina,syncopeSigns:Systolicmurm