《心房解剖》课件.pptVIP

肺静脉解剖 rspv ripv lspv lipv LAa * . * . 左房毗邻 前壁:主动脉，肺动脉 后壁:食道，降主动脉 后下壁:冠状静脉 顶壁: 肺动脉 底部: 左室 * . RA RV A 左房的毗邻 A LV LA RV PA LA LV RA RV PA A 前壁: AO,PA 后壁: 食道，降主动脉 * . * . * . Possible determinants of the risk of thermal damage to the esophagus: 1.fat pad surrounding the esophagus, 2.wall thickness of the LA and esophagus, 3.spatial relationship of the esophagus and LA There is a protective layer of fat between the esophagus and the posterior LA, yet this layer is often discontinuous and, in 2% of normal subjects, completely absent. Esophagus * . Esophagus * . 食管前壁平均厚度1.9- 5.3 mm, LA后壁的平均厚度 1.3- 3.1 mm.食管与LA之间最小距离为 3.3 mm; 1.9+1.3+3.3=6.5 mm Esophagus * . Circulation. 2019;110:3655-3660 Esophagus * . 食管 Esophagus 左房和食管接触的长度和宽度: 长度: 58?14 mm 宽度: 13? 6 mm. 食管和左房之间解剖方向的复杂性: 56%的病人食管与左侧肺静脉平行,其中36%为左上肺静脉向右下肺静脉斜行;其余44%偏右或居中 * . Esophagus * . Relevance of imaging structures adjacent to the left atrium during catheter ablation for atrial fibrillation Heart Rhythm, Vol 7, No 2, February 2010 Volume-rendered three-dimensional CT image of the LA and PV with oral barium enhancement of the esophagus. Irregularity of the contrast-filled esophagus demonstrates normal physiologic peristalsis. A: Left-sided esophagus; B: midline esophagus; C: right-sided esophagus. Figure 3. Relationship of esophagus to posterior LA wall: 3D CT images. Esophagus may be positioned very close to ostia of left-sided PVs (A, PA projection), may have an oblique course from left to right as it travels caudad (B, PA projection), or may be closer to rightsided PVs than left-sided PVs (C, PA projection). In sagittal projection, esophagus wraps around posterior left atrium along its entire length (D). LV indicates left ventricle; CS, coronary sinus; RA, right atrium; SVC, superior vena cava; IVC, inferior vena cava; other Figure 3 Visualization of the esophagus in preprocedural MSCT (left side) versus intraprocedural DynaCT Cardiac. Maximum density projection of 50-mm slice thickness reveals a clear s