外科术后瓣周漏病例封堵术王广义课件.pptVIP

* * Case report: 外科术后瓣周漏病例----封堵术? Transcatheter closure of heart Paravalvular or perivalvular leaks postoperation Guang-yi WANG (王广义；王峙峰；候海军 冯 斌等) Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, CHINA 中国人民解放军总医院 1 Pvl is the common after Valve replacement and repair surgery  Chinese PLA General Hospital Medical therapy is palliative Reoperation carries significant morbidity and Mortality. Percutaneous transcatheter closure techniques, now routinely applied in the management of pathological cardiac and vascular communications, may be Adaptable to PVL closure, potentially offer symptomatic relief. Chinese PLA General Hospital 2. Classification of paravalvular or perivalvular leaks  1.Mechanical prostheses  Aortic Mitral2. Bioprostheses3. Valved stent Chinese PLA General Hospital *Transcatheter closure of prosthetic paravalvular leaks paravalvular leaks after heart prosthetic valve replacement  Chinese PLA General Hospital Antegrade transseptal approachRetrograde transarterial approach Femoral vein－right atrium—puncture atrial septal－left atrium－left ventricle－aorta－femoral artery steel wire track Chinese PLA General Hospital Interventional procedure： 1. 2. Femoral artery－aorta—left ventricle  Devices of paravalvular leaks 1.rashkind Clamshell  CardioSEAL STARFlex 2.coil 3.pfm coil 5.PDA device 6.ASD device 7.VSD device Chinese PLA General Hospital Case 1. aorta paravalvular leak Chinese PLA General Hospital 2. mitral paravalvular leak due to Mechanical prostheses Valve replacement Mitral PVLs Case1. female, 36 yrs, 3 years LV dysfunction after mitral prostheses Valve Replacement. Chinese PLA General Hospital Chinese PLA General Hospital 徐 xx F 56y,二尖瓣单叶瓣机械瓣 Chinese PLA General Hospital C