風濕性心臟瓣膜病

RheumaticvalvulardiseaseLEILIUCardiovascularsurgeryUnderstandingheartstructureValvestructureLeafletvalveannulusChordaePapillarymusclevalvulardiseaseclassification

1Congenitalvalvulardisease2Seniledegenerative

valvulardisease3RheumaticvalvulardiseaseWhatisrheumaticheartdisease?conceptionRelatedtobacterialinfectionRheumaticfeversequelae

Thestructuralabnormalityofasingleormultiplevalvewhenthevalveisinvolvedisadhesion,thickening,hardeningandcontracture.Thechangesofthebloodflowdynamicscausedbythestenosisofthevalveorificeand(or)theclosureofthevalveThickeningofvalve

calcificationofvalve

ThemostcommonvalvelesionsRheumaticheartvalvedisease:Mitralvalve→Aorticvalve→Tricuspidvalve→Pulmonaryvalvemitral→Mtricuspid→Taortic→Apulmonic→PEachvalveEnglishnotesStenosis→SMitralstenosis→MSAorticstenosis→ASInsufficiency→I

Mitralinsufficiency→MI

Aorticinsufficiency→AIDiagnosisMethod1UCG2ECG

3X-rayTreatmentTreatmentoptionsDrugtherapy(relievesymptoms)Interventionaltherapy(goodrecenteffect)Surgery(taketemporarysolutionandeffectapermanentcure)Indication：merely

MSPSOperationmethod：Percutaneousballoondilatation（PBMVPBPV）

Ask:1)nothrombus.

2)goodvalveleafletsactivitythereisnoobviouscalcification.

Interventionaltherapy

Commonoperationmethod:1.Valvuloplasty2.ValvereplacementOperativeTreatmentOperationValvereplacementvalvuloplastybioprostheticvalvedoubleleafMechanicalValveValvuloplasty→PMitralValvuloplasty→MVPTricuspidValvuloplasty→TVP

AorticValvuloplasty→AVPValveReplacement→Rmitralvalvereplacement→MVRTricuspidvalvereplacement→TVRAorticvalvereplacement→AVRValveOperationAbbreviationPostoperativeTreatmentAnticoagulantDrug

1.warfarin

imported3mg/tablet

2.25mg/tablet2.HeparinsodiumRemembertotakeeveryday!PurposeofAnticoagulant1.Topreventbloodclots2.Ensurethenormalfunction

oftheartificialvalveAnticoagulationRequirement

Valvuloplasty：3-6month

Replacement:

Biologicalvalve：3-6month

Mechanicalvalve：foreverPayattentiontotakingwarfarinWarfarinanticoagulationinthebody,vitamin

Kandpharmacologicaleffectsthroughantagonism.CommonlyusedINR(internationalstandardizationratio).Sofixedfood,avoidexcessiveintakeofgreenvegetables,andtoensuretheanticoagulanteffect,reducetheoccurrenceofsideeffects.observethebleedingtendency

Thenasalbleeding

Hemorrhageblack

Bleedinggums

Subcutaneous

Ecchymosis

Preventionasthekeypoint1.preventthehappeningoftherheumaticfever2.Payattentiontotheresidential

health,acutestreptococcusinfec