心脏超声波诊断技术及二尖瓣成形术(英文).ppt
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1、Cardiac Ultrasound Technology and Mitral Valvuloplasty,HE Yihua, LI Zhian Beijing Anahen Hospital, Capital Medical University,Mitral apparatus:annulus、leaflets、chordae tendineae、papillary muscle Saddle shape of annulus,the highest point in the antero-posterior,the lowest point in the medial-lateral
2、Carpentier anatomic description Three orders of chodae tendineae,Anatomy of MV,Echo features of RMS,Most common in the adult (99%) Thickened leaflets; adhesion of commissure; contraction of chordae tendineae Secondary calcification(most in the edge) Multiple leaflets involved,正常,Mitral valve thicken
3、ing、calcification、restricted motion PML and AML: equidirectional motion; city wall changes Decreased EF-slope (non-specific finding) M-mode “A” peak wave disappeared Doming sign,Echo diagnostic key points of balloon mitral valvuloplasty,Severity of MS MVA5mmHg Severity of MR Combined valve disease o
4、r anomaly Mitral valve conditions Degree of mobility and calcification No commissure calcification No subvalvular chordal shortening At rest: SPAP50mmHg At stress: PGmean 15mmHg SPAP 60mmHg,Echo evaluation for MR,Etioloty Severity Location Secondary changes LV function,Echo key point for therapeutic
5、 determination,Etiology vs. therapeutic planning,Rheumatic,Ischemic,Mitral prolapse,Chordal rupture,Myxomatous degeneration,Valve replacement Excision of PML Chordal replacement Artificial chordae Edge to edge repair LV reconstruction Annuloplasty,Echo diagnosis for etiology of mitral diseases,Class
6、ification and Etiology,Normal Leaflet Motion,Restricted Leaflet Motion,Excess Leaflet Motion,TYPE Normal Leaflet Motion Normal valvular motion Leaflet perforation or Cleft valve,TYPE Excess Leaflet Motion Myxomatous degeneration Lack of fibrous framework Chordal rupture,Chordal rupture,Chordal ruptr
7、ue Flail motion Eccentric regurgitation,Mitral prolapse,MVP : Eccentric regurgitation,Valve degeneration,PHVMD definition: Descripted firstly by Rippe et al in 1980 Pathologies MD in the fibrous layer Dissolve Rupture Mucopolysaccharide Protein accumulation No calcification No severe fibrosis Predom
8、inantly involved mitra valve,Echo findings Valve Thickness Redundancy Floppy Billowing or ballooning Prolapse Secondary changes: Regurgitation, chordal rupture,Myxomatous degeneration,Combined valvular involvement,Thickening, floppy, redundancy of mitral valve,Evalve MitraClip,Deploy,Position and Gr
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- 心脏 超声波 诊断 技术 二尖瓣 成形 英文
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