主动脉瓣+肺动脉瓣ppt课件.ppt

单击此处编辑母版标题样式,,单击此处编辑母版文本样式,,第二级,,第三级,,第四级,,第五级,,*,,*,,主动脉瓣疾病,,主动脉瓣狭窄,,Aortic Stenosis AS,,,,病因和病理,,·风心病,,·先天性畸形:二叶瓣畸形,,退行性老年钙化性主动脉瓣狭窄,,,,Normal aortic valve,,先,,天,,性,,Bicuspid aortic valve,,叶,,瓣,,畸,,Left ventricl,,形,,,,Senile aortic stenosis,,ve adonIc w,,Left parasternal,,artic arch,,long axis view,,主动脉瓣钙化,,Bicuspid aortic stenosis,,atrium,,Left ventricle,,,,病理生理,,正常人主动脉瓣口面积三30cm2,,·瓣口面积至1.0cm2时跨瓣压差显著,,√15cm2~1.0cm2:轻度狭窄,,√1.0cm2~075cm2:中度狭窄,,√瓣口三075cm2:重度狭窄,,,,病理生理,,AS→(左室肥厚LⅦH)(向心性)→左心室功能衰竭,,心肌氧耗增加,,心肌毛细血管密度相对减少,,严重AS→舒张期心腔内压力增高,,压迫心内膜下冠状动脉→冠脉血流↓→心肌缺血,,冠状动脉灌注压降低,,,,U,,Narrowed Aortic,,alve("stenotic"),,Vessels to and,,主动,,脉瓣,,al val,,狭窄,,左心室向心,,左室射血负荷增加,,性肥厚,,左心衰竭,,冠状动脉及脑动脉血流减少,,脏性猝死,,,,辅助检查,,·X线检查,,心影正常或左室增大,左房可轻度增大,,升主动脉根部狭窄后扩张,侧位透视主动脉瓣,,钙化,,晚期有肺淤血征象,,,,左大脉扩,,全主狭张,,动后,,,,辅助检查,,上海中山医院心超当,,RV,,AS,,A○,,超声心动图,,LV,,LA,,5胸骨旁长轴切面应示主动脉瓣开,,受限,,,,,,,,,,,,,,,,,,,,,,,,,,。