心臟外科學(xué)講義英文版課件

心臟外科學(xué)講義英文版HeartSurgery心臟外科學(xué)講義英文版CHDPAbloodincreasePAblooddecreaseOtherabnormalitiesofconotruncusOtherabnomalies心臟外科學(xué)講義英文版PAbloodincreaseBloodshutfromleftheartsystemtorightatatrial,ventricularorgreatarterylevelPDAASDVSDAVcanaldefect心臟外科學(xué)講義英文版PDA-PatentductusateriosusroleofductusarteriosusLocationRecurrentlaryngealnerveFailtocloseafter3months

心臟外科學(xué)講義英文版Funnel心臟外科學(xué)講義英文版PhysiologyofPDAL–RshuntPAbloodincreaseLVvolumeoverloadComplication:aneurism,IE,calcification,pulmonaryvasculardiseasePAhypertensionLVenlargement心臟外科學(xué)講義英文版DiagnosisofPDABodysign:continous‘machinery’murmurSBP-DBPincreaseLVenlargeElectriccardiographyEchocardiographyX-rayCardiaccatheterization

心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版TreatmentofPDAClosureOfPDALigationCutAndsultureCPBandpatchclosureTranscutaneouscatheterclosure心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版ComplicationofPDAligationBleedingRecurrentlaryngealnerveinjuryAneurismReopenReflectivehighbloodpressureother心臟外科學(xué)講義英文版ASDPremum–partialatrialventricularcanaldefectSecundem–ostiumSVCIVCmixedCS心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版PathophysiologyofASDL-RshuntingPulmonaryhypertensionPvasculardisEisenmengersyndrome心臟外科學(xué)講義英文版DisgnosisofASDPhysicalexam:SM,P2Subtlesignofheartfailure:exercise,palpitation,arrhythmiasEchoCGElectricCGcatheterization心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版心臟外科學(xué)講義英文版treatmentPFO:80%spontaneousclosurein1st.closurefor:symppomaticpatientssignificantASDL-Rshuntover1.5:1Closureway:surgpercutaneoustranscatheterdevicetransthoraciccatheterdevicetransthoracicscopeassisted

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

minor：1.5—2.0cm2moderate：1.0－1.5cm2

severe：<1.0cm2心臟外科學(xué)講義英文版Ppv↑WholeheartfailureMSPGa-v↑PHRV↑LA↑RVfailure

LVfailure心臟外科學(xué)講義英文版ClinicalManifestationsSymptoms

(1)Dyspnea:Theearliestsymptoms;

(2)hemoptysis,bloodysputum;

(3)cough;

(4)hoarseness;(Signs

(1)mitralvalveface.

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

(3)pulmonaryhypertensionandrightventriculardilatation心臟外科學(xué)講義英文版EchoNMs心臟外科學(xué)講義英文版NMs心臟外科學(xué)講義英文版Aorticstenosis（AS）EtiologyCongenital:Congenitalhypoplasiaoftheaorticvalve,twolobesormultiplelobes;subvavularlocatedstenosis;Acquired:rheumaticorseniledegeneration心臟外科學(xué)講義英文版PathologyandhemodynamicchangesAnaorticvalveitselfincreasedpressureloadASLVHLHFIncreaseinmyocardialoxygenconsumption

IntracardiacdiastolicpressureCoronaryperfusionMyocardialischemia心臟外科學(xué)講義英文版ClinicalInfestationSymptoms:Dyspnea,angina,syncopeSigns:Systolicmurm