主動脈瓣的反流共25張課件

AORTICREGURGITATIONAORTICREGURGITATION1vocabularyperforation[p3fererr穿孔ematurelyI'premetfe(r)過早的Anatomy[enaetemi]geometry[d3ipetri幾何學(xué),構(gòu)成Aortic(er'o.Ikprotracted[[pretraektro]延長的senile[sina]老年性的orifice"orts]孔,洞,反流口Rheumatic[umek風(fēng)濕性surrogate[sNg代理、代表morphology[m3:fled]形態(tài)學(xué)proximalproksImal,近端的commissuraldisruption[dIs'rAp連合中斷中斷;分裂,瓦解;破裂,毀壞vocabulary2AnatomyoftheAorticValveandEtiologyofAorticRegurgitationBasedontheanatomyoftheaorticvalve,ARresultsfromdiseaseofeithertheaorticleafletsand/ortheaorticroot(Table9)thatresultsinvalvemalcoaptationAnatomyoftheAorticValvean3Table9EticlogyandmechanismsofARConcentaMleafletabnormalitiesBicuspid,unicuspid,orquadricuspidaorticvalveentricularseptacquiredleafletabnormalitiesRheumaticdiseaseRadiation-inducedvalvulopathyToxin-inaucedvalvulopathy:anorecticdrugs.5-hydroxytryptamine(carcinoid,Concenial'ceneticaorticAnnuloaorticectasiaConnectivetissuedisease:LoeysDeitz,Ehlers-Danlos,Marfansyndrome,osteogenesisimperfectaAcquiredaorticrootIdiopathicaorticrootdilatationAutoimmunedisease:systemiclupuserythematosis,ankylosingspondyitis,ReiterssyndromeAortitis:syphilitic,Takayasu'sartentisAorticdissectionTraumaTable9Eticlogyandmechanism4SuggestedclassificationofARmorphologyAorticRegurgitationTypeNormalCuspMotionwithAorticDilationorCuspperforationTypeladepictssinotubularjunctionenlargementanddilatationoftheascendingaortaTypeIbdepictsdilatationofthesinusesofValsalvaandsinotubularjunctionTypeIcdepictsdilatationoftheannulus.TypelddenotesaorticcuspperforationSuggestedclassificationofAR5TypellisassociatedwithexcessiveleafletmotionfromleafletprolapseasaresultofeitherexcessiveleaflettissueorcommissuraldisruptionTypelisassociatedwithrestrictedleafletmotionseenwithcongenitallyabnormalvalves,degenerativecalcification,oranyothercauseofthickening/fibrosisorcalcificationofthevalveleafletsTypellisassociatedwithexc61.EchocardiographicImagingInsevereacuteARtheLvisnotdilatedandthesuddenriseinLVend-diastolicpressuremaycausetheMVtocloseprematurely['premetfe(r)lI,bestdocumentedwithanM-modeInchronicAR,echocardiographyisintrackingthechangesinLVgeometry[d3iDmetri](progessiveincreaseinLVvolume)andfunction(progressiveworsening)duetotheprotractedpretraektrdLVvolumeoverload1.EchocardiographicImaging72.DopplerMethodsTheapicalapproachisthemostsensitivefordetectiontheparasternal[pae'.nllongandshortaxisareessentialinevaluatingIIvaeljuerting)theoriginofthejet2.DopplerMethods8ColorflowDopplerBecausethelengthoftheARjetintotheLVchamberissodependentonthedrivingpressure(diastolicbloodpressure),itisnotareliableparameter[paraemIte(o)ofARseveritySI'veretIItisimportanttovisualizevi3uelaIz]thethreecomponentsofthecolorjet(flowconvergence,VC,andjetareaforabetterassessmentoftheoriginanddirectionofthejetanditsoverallseverity(Figure20)ColorflowDoppler9FCsUetheightFigure20ColorflowDopplerofARintheparasternallong-andshort-axisviewsThethreecomponentsofthejetareshownwitharrows:flowconvergence(FC),vC,andJetwidthinLVotintheLvoutflowFC10主動脈瓣的反流共25張課件11主動脈瓣的反流共25張課件12主動脈瓣的反流共25張課件13主動脈瓣的反流共25張課件14主動脈瓣的反流共25張課件15主動脈瓣的反流共25張課件16主動脈瓣的反流共25張課件17主動脈瓣的反流共25張課件18主動脈瓣的反流共25張課件19主動脈瓣的反流共25張課件20主動脈瓣的反流共25張課件21主動脈瓣的反流共25張課件22主動脈瓣的反流共25張課件23主動脈瓣的反流共25張課件24主動脈瓣的反流共25張課件25AORTICREGURGITATIONAORTICREGURGITATION26vocabularyperforation[p3fererr穿孔ematurelyI'premetfe(r)過早的Anatomy[enaetemi]geometry[d3ipetri幾何學(xué),構(gòu)成Aortic(er'o.Ikprotracted[[pretraektro]延長的senile[sina]老年性的orifice"orts]孔,洞,反流口Rheumatic[umek風(fēng)濕性surrogate[sNg代理、代表morphology[m3:fled]形態(tài)學(xué)proximalproksImal,近端的commissuraldisruption[dIs'rAp連合中斷中斷;分裂,瓦解;破裂,毀壞vocabulary27AnatomyoftheAorticValveandEtiologyofAorticRegurgitationBasedontheanatomyoftheaorticvalve,ARresultsfromdiseaseofeithertheaorticleafletsand/ortheaorticroot(Table9)thatresultsinvalvemalcoaptationAnatomyoftheAorticValvean28Table9EticlogyandmechanismsofARConcentaMleafletabnormalitiesBicuspid,unicuspid,orquadricuspidaorticvalveentricularseptacquiredleafletabnormalitiesRheumaticdiseaseRadiation-inducedvalvulopathyToxin-inaucedvalvulopathy:anorecticdrugs.5-hydroxytryptamine(carcinoid,Concenial'ceneticaorticAnnuloaorticectasiaConnectivetissuedisease:LoeysDeitz,Ehlers-Danlos,Marfansyndrome,osteogenesisimperfectaAcquiredaorticrootIdiopathicaorticrootdilatationAutoimmunedisease:systemiclupuserythematosis,ankylosingspondyitis,ReiterssyndromeAortitis:syphilitic,Takayasu'sartentisAorticdissectionTraumaTable9Eticlogyandmechanism29SuggestedclassificationofARmorphologyAorticRegurgitationTypeNormalCuspMotionwithAorticDilationorCuspperforationTypeladepictssinotubularjunctionenlargementanddilatationoftheascendingaortaTypeIbdepictsdilatationofthesinusesofValsalvaandsinotubularjunctionTypeIcdepictsdilatationoftheannulus.TypelddenotesaorticcuspperforationSuggestedclassificationofAR30TypellisassociatedwithexcessiveleafletmotionfromleafletprolapseasaresultofeitherexcessiveleaflettissueorcommissuraldisruptionTypelisassociatedwithrestrictedleafletmotionseenwithcongenitallyabnormalvalves,degenerativecalcification,oranyothercauseofthickening/fibrosisorcalcificationofthevalveleafletsTypellisassociatedwithexc311.EchocardiographicImagingInsevereacuteARtheLvisnotdilatedandthesuddenriseinLVend-diastolicpressuremaycausetheMVtocloseprematurely['premetfe(r)lI,bestdocumentedwithanM-modeInchronicAR,echocardiographyisintrackingthechangesinLVgeometry[d3iDmetri](progessiveincreaseinLVvolume)andfunction(progressiveworsening)duetotheprotractedpretraektrdLVvolumeoverload1.EchocardiographicImaging322.DopplerMethodsTheapicalapproachisthemostsensitivefordetectiontheparasternal[pae'.nllongandshortaxisareessentialinevaluatingIIvaeljuerting)theoriginofthejet2.DopplerMethods33ColorflowDopplerBecausethelengthoftheARjetintotheLVchamberissodependentonthedrivingpressure(diastolicbloodpressure),itisnotareliableparameter[paraemIte(