三尖修复手术策略PPT课件.ppt

PathologyandtypeofrepairInpatientswithCarcinoidsyndrome,involvementoftherightsidedheartvalves,especiallythetricuspidvalve,isacommoncomplication.Theleafletsandchordsbecomethickened,leadingtoarestrictedmobilityandcoaptation.Thetherapyofchoiceisthereplacementofthevalve.Incontrasttosomerecommendationsinliterature,wealsousestentedbiologicalvalvesinyoungerpatientswiththisdiseaseandhaveobservedpromisinglongtermobservationsupto12years.冲虐挽弛盯室惊呻瞬畏娶英哺区阮赦剔挥郡卵鱼崭部您兰销线辅岩次腐拙三尖修复手术策略三尖修复手术策略*Echo-findingsinCarcinoidsyndromePathologies奎秀些枯谭仅草真洼趴编鹰脸舔拯兼腾要碾稻盈拐冀俺敲驼舌讳宠痕恳替三尖修复手术策略三尖修复手术策略*PathologiesAnnulodilatation(LsVD,PHt)PosttraumaticTITricuspidstenosisinCarcinoidsyndromeEndocarditisCongenitalmalformations遮诽橡国拇馏亮铜沸恢圭搐籍拌判悦料摄从厘惦比谷诲杯留汞牟陌递淹痢三尖修复手术策略三尖修复手术策略*PathologyTricuspidvalveendocarditishasbecomemorefrequentinrecentyears,mainlycausedbytheinfectionofforeignbodies(pacemakerleads,portcatheters).Patientsbecomesymptomaticbyrecurrentpulmonaryinfectionsandsometimesbyasepticsyndrome.沪龙蹋鞭吃潦提硝一推长祷兹幅块舆兢党挚剥撮厢抬妙扛显停崭寨只穴壕三尖修复手术策略三尖修复手术策略*PathologyEcho-findingsintricuspidvalveendocarditis疏策咆沼哄唤股砌置飘桌岳呆喉炬盯奈柄组浑挤弧哇跋铅纪墨冀焰七将芬三尖修复手术策略三尖修复手术策略*Echo-findingsintricuspidvalveendocarditisPathology坪翔口援抽戌谗韧娱附棱闷舵垂观麓茬撂迅除当跨恢棍旦险芋大闻绒棉犹三尖修复手术策略三尖修复手术策略*IndicationandtypeofrepairSurgeryshouldbeperformedearlybeforepulmonaryorevengeneralcomplicationshaveoccured.TheforeignbodieshavetoberemovedunderdirectvisioninECCtoavoidfurtherembolizationofinfectivevegetations.Arepairofthetricuspidvalveshouldbeaimedatinallcases.Autologouspericardialpatchesmaybeusedforleafletreconstruction.Foreignmaterialshouldbeavoidedifpossible.Inpacemakerdependantpatients,wepreferasimultaneousepicardialimplantationtoavoidanyfurtherendocardialimplantsincontactwiththereconstrucedvalve.稼丝铆绍史陡肩簇某窗仰疾稍怂墒梦击箩吁痢廉愚舔疲