AMG4 Curs Valvulopatii M Ao

VALVULOPATII VALVULOPATII MITRALE & AORTICEMITRALE & AORTICE

Antoniu Petris MD, PhD, FESCAntoniu Petris MD, PhD, FESC

“St. Spiridon” Hospital Iasi, Romania““St. St. SpiridonSpiridon”” Hospital Iasi, RomaniaHospital Iasi, Romania

UMF “Gr. T. Popa” Iasi, RomaniaUMF UMF ““Gr. T. Gr. T. PopaPopa”” Iasi, RomaniaIasi, Romania

© Toate drepturile rezervate dr. Antoniu Petris

44--6 cm6 cm22


Valva aotica normala inchisa - deschisa

22--3 cm3 cm22

Sutton GC, Chatterjee K, 1998Sutton GC, Chatterjee K, 1998


STENOZA MITRALA

INSUFICIENTA MITRALA


STENOZA AORTICA

INSUFICIENTA AORTICA


STENOZA MITRALA


AglutinareAglutinare sisifibrozarefibrozare

cordajecordaje 15%15%

FuziuneFuziunecuspecuspe 15%15%

IngrosareIngrosare sisifuziunefuziune comisuricomisuri

30%30%

+ + combinatiicombinatii 40%40%


“gura de peste”““guragura de de pestepeste””

StenozaStenoza mitralamitralaBinottoBinotto MA et al. Images in MA et al. Images in PaedrieticPaedrietic CardiolCardiol 2002; 11: 122002; 11: 12--3131

Stenotic mitral valve seen from left atrium. Both commissuresare fused; the cusps are severely thickened. The left atrium is huge. The valve is both incompetent and stenotic.


StenozaStenoza mitralamitralaBinottoBinotto MA et al. Images in MA et al. Images in PaedrieticPaedrietic CardiolCardiol 2002; 11: 122002; 11: 12--3131

Opened stenotic mitral valve showing thickening distorted cusps, adherent commissures with calcification and thrombus deposition, and thickening, fusion and shortening of chordaetendinae.

Opened stenotic mitral valve showing thickening distorted cusps, adherent commissures with calcification and thrombus deposition, and thickening, fusion and shortening of chordaetendinae.


B:F = 1:2

Din valvulopatiile reumatice:

25% stenoze mitrale puse

40% boala mitrala (SM + IM)

< 2 cm2 – gradient AS-VS doar la efort (SM larga)

1.5-2 cm2 gradient VS-AS in tahicardie (SM moderata)

1-1.5 cm2 - gradient permanent (SM moderata)

< 1 cm2 – gradient critic = 20 mmHg si PAS > 25 mmHg si PCP > 20-25 mmHg (SM severa)


Examen radiologic – cord configurat mitral prin hipertrofia şi dilatarea atriilor şi ventriculului drept; stază pulmonară până la aspect de edem pulmonar

Examen radiologic – cord configurat mitral prin hipertrofia şi dilatarea atriilor şi ventriculului drept; stază pulmonară până la aspect de edem pulmonar


INSUFICIENTA MITRALA


Stenoza mitrala Insuficienta mitrala


STENOZA AORTICA


Stenoza aortica reumatismala sisenoza aortica senila



Valva aortica bicuspida calcificata



http://cueflash.com/decks/Cardiovasc_Path


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DilatareDilatare postpost--stenoticastenoticaa a aorteiaortei ascendenteascendente


INSUFICIENTA AORTICA


http://wikidoc.org/index.php/Aortic_Regurgitation_Chest_x-ray


AMG4 Curs Valvulopatii M Ao

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