2019年《心房解剖》ppt课件.ppt
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1、心房及其毗邻的解剖与影像学对消融治疗的指导意义,Cavotricuspid Isthmus,三尖瓣环与欧氏瓣和下腔静脉开口之间的峡部宽度约为23cm,是房扑折返环中最窄、传导最为缓慢的共同通道。峡部肌小梁交错、重叠,电传导各向异性并呈双向传导。,Fischer等将右房峡部分为三区 区:三尖瓣环下腔静脉 成功率70% 区:三尖瓣环冠状窦口 成功率30% 区:冠状窦口下腔静脉 成功率10%,Figure 6.,Figure 5,Illustration showing the importance of obtaining both RAO and LAO views to ascertain m
2、ultielectrode catheter position. The top panel in the RAO view the catheter tip points posteriorly. The bottom panel shows correct positioning of the catheter. Note the tip of the catheter is in the plane of the CS and when advanced will not advance posteriorly as the case when positioned behind the
3、 Eustachian ridge.,左心房,左房腔体 心耳 肺静脉口 二尖瓣环,左房腔体,Heart Rhythm, 7(2):269 2010,左房腔体,The heart has been cut through the “ridge“ to show its pointed profile formed by the infolding of the atrial wall. Note the continuation of LA musculature onto the LSPV. The broken line marks the isthmus between the orifi
4、ce of the LIPV and the mitral annulus.,左房腔体,Heart Rhythm, 7(2):269 2010,Carina,carina fibers must have an endocardial to epicardial route near the perimeter of the veins and thus are less amenable to endocardial ablation at the perimeter周界.,compact atrioventricular node,Compact Atrioventricular Node
5、,Heart Rhythm, 7(2):269 2010,肺静脉,77%的人有双侧肺静脉 左侧肺静脉开口较右侧高 下肺静脉的开口更接近于后壁 上肺静脉与水平面的夹角较下肺静脉大,AFCARTO MERGE,左心房肺静脉解剖变异,肺静脉解剖,肺静脉解剖,左房毗邻,前壁:主动脉,肺动脉 后壁:食道,降主动脉 后下壁:冠状静脉 顶壁: 肺动脉 底部: 左室,左房的毗邻,前壁: AO,PA,后壁: 食道,降主动脉,Possible determinants of the risk of thermal damage to the esophagus: 1.fat pad surrounding the
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