心脏超声波诊断技术及二尖瓣成形术(英文).ppt

单击此处编辑标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,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,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 thickening,、,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 evaluation for MR,Etioloty,Severity,Location,Secondary changes,LV function,Echo key point for therapeutic 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,Classification and Etiology,Normal Leaflet,Motion,Restricted Leaflet Motion,Excess Leaflet,Motion,TYPE,Excess Leaflet Motion,Myxomatous degeneration,Lack of fibrous framework,Chordal rupture,Mitral prolapse,MVP:,Eccentric regurgitation,Valve degeneration,Valve degeneration,CVMD,PCVMD,Fiber loss of elastic tissue disease,Calcification,SCVMD,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 Grasp,Coronary,Sinus,Reshaping,Coronary Sinus Annuloplasty,-Edwards Monarch,-Cardiac DimensionsCarillon,-Viacor PTMA*,Direct Annulus Plication,-Mitralign,-Guided Delivery Systems,Posterior,Annular,Reshaping,Coronary Sinus-,Atrial Reshaping,Left Ventricular Shape Change,-Myocor(Surgical/Perc),Trans-Atrial Shape Change,-Ample PS,3,System,Device,Schematic,Mechanism,LV Antero-,Posterior,Reshaping,Current Percutaneous Technology for Functional MR,Myocor Transpericardial Mitral Repair,Courtesy of Wes Pederson,Abbott,Minneapolis,Minnesota.,Echo diagnosis for location of mitral diseases,TEE,Echo diagnosis for location of mitral diseases,TEE,Echo diagnosis for location of mitral diseases,3-Dimensional echo and intraoperative findings,Echo diagnosis for location of mitral diseases,Echo quantification for severity of mitral disease,Quantification of MR,Jet length:,、,、,、,Quantification of MR,PISA method,ERO=(2r,2,x V,PISA,)/MR-V,maxv,RV=ERO X MR,TVI,Quantification of MR,Development of 3D Echo,Intraoperative location,Study of annular function,Study of ERO,Signification of studying annular morphology,Functional MR,Organic MR,Changes of annular morphology and function,Optimal surgical procedure,Current status of mitral annular study,Radioactive material labeled,Animal experiment,Invasive study,Measurement variables,Height,Projection area,M-A,Antero-posterior diameter,Longitudinal Displacement and velocity of annulus,IMR,MVP,Annulus flattened,、,increased Antero-posterior diameter,穹隆体积增加,No obvious change of annular shape,Dynamic change of 3D-MVA,During a cardiac cycle,0.00,0.18,0.36,0.72,0.90,3D analysis of mitral valve,Coaptation area and index,Coaptation index,=,Surface area in early diastole,Surface area in late systole,Surface area in early diastole,Coaptation area,Coaptation area and index,Coaptation area and index,Quantification of tenting volume,Intraoperative monitoring,Complications of annuloplasty,Residual MR,Residual or new MS,SAM,or prosthetic strut protrusion with LVOT obstruction,Left or right ventricular dysfunction,Coronary occlusion from annuloplasty or valve ring suture,Pseudoaneurysm formation at site of debridement of mitral annular calcification,Shunts related endocarditis,AR secondary to suture placement or annular distortion,Embolism events,3D TEE Pre-Procedure,After anesthesia,Before anesthesia,Evaluation for MR at different status,