心臟外科學講義英文版課件

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

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

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

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

minor：1.5—2.0cm2moderate：1.0－1.5cm2

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

LVfailure心臟外科學講義英文版ClinicalManifestationsSymptoms

(1)Dyspnea:Theearliestsymptoms;

(2)hemoptysis,bloodysputum;

(3)cough;

(4)hoarseness;(Signs

(1)mitralvalveface.

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

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

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