心脏外科学讲义英文版.ppt

Heart Surgery WuChangXue Dept of thoracic cardiovasclar surgery,LZMC PA blood increase Blood shut from left heart system to right at atrial, ventricular or great artery level PDA ASD VSD AV canal defect PDA-Patent ductus ateriosus role of ductus arteriosus Location Recurrent laryngeal nerve Fail to close after 3 months Physiology of PDA Diagnosis of PDA Body sign: continous ‘machinery’ murmur SBP-DBP increase LV enlarge Electric cardiography Echocardiography X-ray Cardiac catheterization Treatment of PDA Complication of PDA ligation Bleeding Recurrent laryngeal nerve injury Aneurism Reopen Reflective high blood pressure other ASD Premum– partial atrial ventricular canal defect Secundem– ostium SVC IVC mixed CS Pathophysiology of ASD L-R shunting Pulmonary hypertension P vascular dis Eisenmenger syndrome Disgnosis of ASD Physical exam: SM, P2 Subtle sign of heart failure: exercise ,palpitation,arrhythmias Echo CG Electric CG catheterization treatment PFO:80% spontaneous closure in 1st. closure for :symppomatic patients significant ASD L-R shunt over 1.5:1 Closure way: surg percutaneous transcatheter device transthoracic catheter device transthoracic scope assisted VSD Perimembranous Muscular Subarterial Atrioventricular Pathophysiology of VSD L-R shunting P blood increase LV volume overload PH Eisenmenger syndrome Disgnosis of VSD Physical exam: SM, P2 Subtle sign of heart failure: exercise intolerance,palpitation, arrhythmias Echo CG Electric CG catheterization Treatment Spontanous clsoure closure for :symppomatic patients large VSD Closure way: surg percutaneous transcatheter device transthoracic cathe