心脏超声波诊断技术及二尖瓣成形术（英文）PPT.pptVIP

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: Ⅰ、Ⅱ、Ⅲ、Ⅳ Quantification of MR PISA method ERO = (2∏r2 x VPISA) / MR-Vmaxv RV = ERO X MRTVI Quantification of MR Development of 3D Echo Intraoperative location Study of annular function Study of ERO 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 diagnostic key points of balloon mitral valvuloplasty Severity of MS MVA1.5cm2 PGmean5mmHg Severity of MR Combined valve disease or anomaly Mitral valve conditions Degree of mobility and calcification No commissure calcification No subvalvular chordal shortening At rest: SPAP＞50mmHg At stress: PGmean ＞ 15mmHg SPAP ＞60mmHg 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 Echo diagnosis for etiology of mitral diseases Classification and Etiology Normal Leaflet Motion Restricted Leaflet Motion Excess Leaflet Moti