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IVC, SVC RA overload RV dialated PA dialated Pulmonary congestion Pulmonary veins  LA LV volume decreased Aortic volume decreased Systemic volume  decreased  ASD  
Hemodynamic changes in ASD ,[object Object],[object Object],[object Object],[object Object],[object Object],ASD
Why the left atrium is no enlarge with ASD ? LV RV LA RA
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Subcostal four chamber view
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返回
 
 
 
 
Amplatzer 双盘样闭合器
After plantation   四腔位  正位
 
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[object Object],[object Object]
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VSD classification 1: membranes  2:outflow  3:inflow  4:muscular ① ② ③ ④
 
IVC, SVC RA RV dialated PA dialated Pulmonary congestion LA overload LV overload Aortic volume decreased Systemic volume  decreased  VSD   Hemodynamic changes in VSD Pulmonary blood overload
Hemodynamic changes in VSD
Hemodynamic changes in VSD ,[object Object],[object Object],[object Object],[object Object],[object Object],VSD
Why the left atrium can enlarge with VSD? LV RV LA RA
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In moderate- large VSD CXR: cardiac enlargement and increased PA flow ECG: may variable In large defect CXR:marked cardiomegaly,and increased pulmonary  Vascularity ECG: RVH, LVH, or both Echocardiography: defining position and size Doppler echo: estimate the pulmonary systolic pressure
 
 
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patch Direct to sow up 返回
Orbit way : FV ->IVC ->RA->RV ->VSD -> LV ->AAO ->DAO ->FA
 
 
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Hemodynamic changes in PDA RA RV PA congestion PA congestion LV dialated Ao Systemic volume decreased PA dialated Descending ao dialatd Ascending ao dialatd PH Diastolic BP decreased PDA   LA dialated
Hemodynamic changes in PDA ,[object Object],[object Object],[object Object],[object Object],[object Object],PDA
Patent Ductus Arteriosus   RA LA RV LV PA Ao
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Left atrium and ventricular hypertrophy
肺多血,肺动脉段
 
[object Object],[object Object],[object Object],[object Object],[object Object],Large shunt PDA: similar to VSD
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蘑菇伞堵塞术(图示) PDA
 
 
 
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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hemodynamic changes in TOF ,[object Object],[object Object],[object Object],VSD VSD LV AO overriding cyanosis RV PA blood flow decreased
[object Object],[object Object],[object Object],[object Object],Severe degree of the presentations is related to the degree of right ventricular outflow obstruction.
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[object Object],[object Object],[object Object],[object Object],[object Object]
cyanosis
Squatting 蹲踞
Thrombosis
Clubbing
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Boot -shape
 
 
 
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cyanosis   RVOT contract  R  Lshunt  hyperpnea Sat%  Venous return  R  Lshunt  hyperpnea
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Blalock-Taussig  The anastomosis between  Subclavian artery and  Ipsilateral PA Gor-tex interposition shunt between Subclavian artery and Ipsilateral PA
Conventional repair surgery
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