心脏超声波诊断技术及二尖瓣成形术（英文）.ppt

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 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 Echo diagnostic key points of balloon mitral valvuloplasty Echo evaluation for MR Echo key point for therapeutic determination Etioloty Severity Location Secondary changes LV function Etiology vs. therapeutic planning TYPEⅡ Excess Leaflet Motion Myxomatous degeneration Lack of fibrous framework Chordal rupture Chordal rupture Chordal ruptrue Flail motion Eccentric regurgitation Mitral prolapse MVP : Eccentric regurgitation Valve degeneration PHVMD definition： ⊙ Descripted firstly by Rippe et al in 1980 ⊙ Pathologies MD in the fibrous layer Dissolve Rupture Mucopolysaccharide Protein accumulation No calcification No severe fibrosis ⊙ Predominantly involved mitra valve Myxomatous degeneration Echo findings Valve ◆ Thickness ◆ Redundancy ◆ Floppy ◆ Billowing or ballooning ◆ Prolapse Secondary changes： Regurgitation, chordal rupture Combined valvular involvement Thickening, floppy, redundancy of mitral valve Echo quantification for severity of mitral disease Quantification of MR Quantification of MR Jet length: Ⅰ、Ⅱ、Ⅲ、Ⅳ Quantification of MR PISA method Development of 3D Echo Signification of studying annular morphology Current status of mitral annular study Measurement variables 3D analysis of mitral