右室双出口英文答题.ppt

Double Outlet Right Ventricle (DORV) WEI NI In a normal heart structure, the aorta connects to the left ventricle, In a normal heart structure : the aorta connects to the left ventricle t he pulmonary artery connected to the right ventricle In a normal heart structure, the aorta connects to the left ventricle, In a normal heart structure : the aorta connects to the left ventricle t he pulmonary artery connected to the right ventricle 1. with or without transposition of the great arteries 2. ventricular septal defect (VSD) ulmonary hypertension or p ulmonary stenosis (PH or PS) What if there are defects : Definition “ DORV is a type of congenital heart disease which both great arteries arise either entirely or predominantly from the right ventricle ” The Society of Thoracic Surgeons(STS ) And European Association for Cardio-Thoracic Surgery(EACTS ) ----2000 100 % > 50% spatial relationship of the semilunar cusps in hearts with DORV Ⅰ . Great Arteries Relationship D- malposition ( 12% ) L- malposition ( 5% ) Parallel ( 29% ) Normal AN AA Ⅱ. Location of VSD Classification of the interventricular communication / VSD according to its location in relation to the great arteries ? subaortic (65%) ? subpulmonary (20-25%) ? mitted (3%) ? mitted (7%) A vast importance to surgical operation,rather than anatony or embryology ? size in relation to the diameter of the aorta ? distance between VSD and aortic valve(overriding > 70% ) ? presence and severity of a subpulmonary obstruction subaortic VSD VSD belows the aortic valve overriding > 70% PH or PS subaortic VSD parasternal long axis Ao Ao LV LA RV RV Ao PA subaortic VSD with severe pulmonary stenosis subaortic VSD PA Ao subpulmonary VSD ? size in relation to the diameter of the pulmonary artery ? presence and severity of a subpulmonary obstruction VSD belows the pulmonary valve Overriding PH or PS