经皮瓣膜成形术技巧： 主动脉瓣狭窄 （适应证、操作及并发症）
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经皮瓣膜成形术技巧： 主动脉瓣狭窄 （适应证、操作及并发症）. 中国医学科学院 北京协和医学院 心血管病研究所 阜外心血管病医院 蒋世良. 经皮主动脉瓣球囊成形术（ percutaneous balloon aortic valvuloplasty ， PBAV ）是利用球囊扩张的机械力量使粘连的主动脉瓣叶交界处分离，以缓解瓣口狭窄程度. PBAV 术简史. 1984 年 Lababidi 等首次报道应用经皮球囊扩张术治疗先天性主动脉瓣狭窄，取得良好的临床效果 1985 年 Cribier 等采用该技术治疗老年性主动脉瓣狭窄获得成功 我国于 1986 年引进该技术 - PowerPoint PPT Presentation
Transcript of 经皮瓣膜成形术技巧： 主动脉瓣狭窄 （适应证、操作及并发症）
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percutaneous balloon aortic valvuloplastyPBAV
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PBAV1984Lababidi1985Cribier1986
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PBAVAlec Vahanian 2004
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PBAV
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CoreValve Self-Expanding Bioprosthesis
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Morphological Quantification Aortic valve annulus diameter: 20-24 (27) mmAscending aorta diameter: < 45 mm
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1. 2. 50mmHg 3.
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1. 2. 3. 4.
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5. 1 2 3
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Judkins
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Inoue
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1X 2 3 1
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4 0.035 145cm0.032145cm 260cmInoue
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5C
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6789
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0.035260cm
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/0.81.01:389
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Inoue0.032260cm
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Inoue1:3
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5025
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8h20h6h24h
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13d13612X
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Inoue13612X
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*NOTICE THAT THE COREVALVE FRAME (INFLOW) IS WELL ENGAGED IN THE AORTIC ANNULUS AND THE OUTFLOW PORTION OF THE COREVALVE FRAME IS WELL ENGAGED WITHIN THE ASCENDING AORTA.THE CORONARY ARTERIES ARE NOT JAILED BECAUSE OF THE UNIQUE DESIGN OF THE SUPPORTING FRAME (CONVEXO-CONCAVE CONFIGURATION). THE CORONARY SINUS IS AWAY FROM THE FRAME AND CAN BE EASILY CANALIZED FOR ROUTINE ANGIOGRAPHY, OR INTERVENTIONAL PROCEDURE SUCH AS ANGIOPLASTY OR STENTING.
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