实时三维超声心动图_叶维国.pptVIP

实时三维超声心动图：即将到来的时代 GWICC-第20届10月10号，2009 叶维国 医学博士 副教授, 心脏科 内科及药物治疗系 威尔斯亲王医院 香港中文大学 完整关护周期新理念 预防 筛查 诊断 治疗 二级预防 治疗及随访 家庭照顾 经皮心腔内介入治疗 二尖瓣外科治疗 (二尖瓣狭窄/二尖瓣脱垂/连枷瓣 / 缺血性二尖瓣反流) 经皮二尖瓣钳MitraClip? system 经皮二尖瓣球囊扩张术(PBMV) 监测二尖瓣修复/置换外科手术后监测效果 经皮主动脉瓣置换 房间隔缺损/卵圆孔封堵 左心耳封堵 经皮二尖瓣钳(EValve) 导引钢丝和鞘管放置 左心耳封堵(Watchman) 展望未来 小型化(儿科, 心腔内超声) 更好的时间及空间分辨率 单个心动周期广角实时+/-血流显像 组织多普勒/ 应变 (经食管超声心动图) 软件 动态二尖瓣分析 左心室功能及力学 右心室定量 与其他三维显像的结合 (心脏磁共振/CT) Conclusions 在过去20年中，三维超声心动图取得了革命性的进步，促进了疾病早期筛查、诊断、治疗引导和效果监测 技术不断进步将继续惠及患者 “ Minimally Invasive Interventions ” Live 3D Echo : Age of Coming  20th GWICC Saturday, October 10, 2009 Gabriel Yip, MD FASE FACC Associate Professor, Division of Cardiology Department of Medicine Therapeutics The Chinese University of Hong Kong Prince of Wales Hospital, Hong Kong, China Care Cycle Concepts Prevention Screening Diagnosis Treatment Secondary Prevention Management Follow-up Home Care Percutaneous Intracardiac Intervention Mitral Valve Surgery (MS/MVP Flail/ Ischemic MR) Percutaneous MitraClip? system Percutaneous balloon mitral valvuloplasty (PBMV) Monitor surgical outcome after repair/replacement Percutaneous aortic valve replacement ASD/PFO closure Left atrial appendage occlusion Percutaneous MitraClip (EValve) Left Atrial Appendage Occluder What’s Next? Miniaturization (for pediatrics, ICE) Better time and spatial resolution Wider Angle Real-time Single beat +/- Color Flow Tissue Doppler/ Strain (TEE) Software Dynamic MV analysis LV function and mechanics RV quantitation Fusion with other 3D imaging (CMR/CT) Conclusions Over past 20 years, remarkable evolution in 3D echocardiography that has enhanced early screening, diagnosis, guiding treatment, and monitoring It is expected the trend of improvement will continue to grow with ultimate benefits to patients Courtesy of Dr Vahanian and Dr Brochet Bichat Hospital, Paris, France PBMV in Mitral Stenosis PBMV in Mitral Stenosis PRE PBMV POST PBMV Courtesy of Dr Vahanian and Dr Broc