医学ppt课件先心病室间隔缺损.pptVIP

Patient Selection Defects smaller than 20-25mm in diameter Should not have defects in the very upper or lower portions of the septum Ostium Primum or Sinus Venosus, not good candidates because defect usually involves heart valves or abnormal venous drainage from the lungs Only benefit Ostium Secundum defects No lower age limit, but must weigh more than 8-10 kg Trans-catheter Approach Device is advance through an introducer sheath One- Half of the device is deployed on left side of atrial septum, the second half is deployed on the right side A “sandwich” is formed over the defect 6-8 weeks, device as a frame work for scar tissue to form In children the new tissue formation with continue to grow TTE post Intervention Transesophageal echocardiogram showing Amplatzer device placed across the defect forming a “sandwich” over the atrial septal defect 根据三原色原理叠加后的单色形成了第三种颜色并脱离了原本的单色颜色更加丰富象征着产品在原有空间的组合中产生了突破性的变化 Atrial Septal Defect Kendra Marsh, MD Division of Cardiology, UIC Fellow Embryology Gestational Week 4 Gestational Week 4-6 ? A thin, crescent shaped wedge of tissue of (septum primum) grows towards and fuses with endocardial cushions. The remaining opening is called the ostuim primum. ? As the septum primum is growing down, the endocardial cushions fuse and the ostium primum is eventually obliterated. Embryology The interatrial septum forms during the first and second months of fetal development. Stage I is the formation of the septum primum. The septum primum walls off a crescent-shaped portion of the hole between the right and left atria. Foramen primum (also called the ostium primum) stays open The remaining part of the opening between the right and left atria is closed by the septum secundum. The 2 tissue layers overlap like a flap, allowing blood flow to continue during fetal life. Changes in circulation at birth, closes the flap permanently. Anatomy and Physiology Extends from cavo-atrial junction with superior and inferior vena cavae En