天津医科大学内科学课件 Valvular Heart Disease.pptVIP

TAVI AS -Complications Sudden death Heart failure Arrhythmia Infective endocarditis Systemic embolism AS - Medical Management Patient education Medications-patients with associated hypertension or CHF can be treated with medications if AS is mild or moderate Caution if severe AS, especially with beta blockers and dilator type agents Favor use of statin drugs AS -Medical Management Periodic echo-if mild AS: echo every 2 years; for moderate AS every year, and for severe AS echo assessment every 6-8 months Question the role of Subacute Bacterial Endocarditis (SBE) prophylaxis ?  Valvular Heart Disease Xin Du, MD Cardiovascular Centre Learning Objectives To master the etiology, pathology, pathophysiology, clinical manifestations and diagnosis of common valvular diseases To be familiar with differential diagnosis, complications and basic principles for medical and surgical treatment To learn the trends in the incidence of common valvular diseases in developing and developed countries Valvular Heart Disease (VHD) Valvular heart disease includes a number of common cardiovascular conditions It accounts for 10% to 20% of all cardiac surgical procedures It is found in 4% of patients over the age of 65 in the developed countries Heart and Valves Normal Valve Function Maintain forward flow and prevent reversal of flow Valves open and close in response to pressure differences (gradients) between cardiac chambers Abnormal Valve Function Valve Stenosis Obstruction to valve flow during that phase of the cardiac cycle when the valve is normally open Hemodynamic hallmark -“pressure gradient” Valve Regurgitation, Insufficiency, Incompetence Inadequate valve closure--- back leakage A single valve can be both stenotic and regurgitant Combinations of valve lesions can coexist Single disease processes Different disease processes One valve lesion may cause another Certain combinations are particularly burdensome (AS MR) ?Valvular Heart Disease Aortic Stenosis (AS)