04 hẹp van động mạch chủ vai trò của siêu âm

HEP VAN DONG MACH CHU

VAI TRO CUA SIEU AM

Bs CK2 Lé Thi Dep

we TIM

— | Ny

waite game TÚ lS ot i

Dai cvong (t

>La bén én rn viém,Khhooadnnvogng
Gilani pu, yng, tu ching pn ut
tng mau

>Sieu am: iu chug tàn

Tact gang lh ep van MC rng mau ching,
huyét ng kn tong Ung hay 0 tn eng eu ong hap

VALVULAR HEART DISEASE:A COMPANION TO BRAUNWALD'S HEART DISEASE, FIFTH EDTION, at

Dai cvong (2

Plu ti niko: Krdng glam tn tiénvé mathuyet

dng

»Phau thud SAV); cut uốn

>Thay van qua dutg ong ÔN (TAVR }:nguy cot
vong tung binh hay cao, Nhung ket cuc lam sang sau

nam van con thieu

\VALVULAR HEART DISAECAOMPSANEION TOBRALNVIALDS HEART DISEASE. FIFTH EDITION, 2021

Dai wong (3}

›Thtửm tú) 6 nut cao tdi: 12> 75 tu.
> - 34 mng> 65 tui ving Ki dn gi
›Tnbj án lẻ lâm sàng, i tuyén va phn

› BằIị ae machchu (AVRth)ay ta động
machch qua Gg tng (TAVR)

> Gi té tt bénhva ty é te vong ola SAVR va TAVR

ULAR HEART DISEASE: ACOMPANION TO RALNALDS HEART DISEASE, FFTHEDIION 201

s Cac gial doane va quan ly AS (4) Ngwjo ting
tréuchimg)
Biting minh (2), <2mis Bh tuing Kem atquuco 0a

Yo Wa hog can da he mach mau

Wan tinh tring Savnn lla ci u(oth van
bin it

Khdng sith hing gah hi)

Tenn (ing Viúabgllluglih 2m, ¢4 EF2S1400 Then ding sud:
mis {= nm nu hep tung tinh
tnuching) Maven ghana ìmll‹\Ћ 4.5 nm ep

dt

i NangttogbuVbifaidnmdgan, >4
gi han AP 240mm

Nang kg ti FSM Theol bing su Am dl»12
ching vi EF bah UH thing
fFthuong Dahgi lm sing

Nang Kg VOinhg vdd mdavan Cann ging so
AR
chivnigEF gid gthan

VALVULAR HEART DISEASE:A COMPANION TOBRAUNWALDS HEART DISEASE, FIFTH EDTIO, at

Cac giai doan va quan ly AS (2}

BSNing ob tigu L5 — |

ching (4m WH AR
AP2d0 mmg OD
Chenh dp cao PHT

AAStom EF<ðW DSE loa rg AS néng va xdo
ij Vag 4 ms
AP <40 mml4g dinh dy tt co bop
LG-EF gdm
CoHEAVR
LG-EF binh Tim cdc nquyén han iam EF
kha
lờ AAStom® — EF 260% Kim sot hye (40
AVAIS omélm? LVH ning mi)
\ „4m DD gti han Lal tI do dao
AP ŸI4nllt them
Canc do hsb vihta
COINEAR

\VALVULAR HEART DISEASE: ACOMPANION TO BRAUNHEIARVT AOSELASED, SFIFTH EDITION, 201

Nguyen nhan va am sang (4)

Pho bién Lo tui Bénh xo va mach van
Wungtudađhg %jM
mach

Tin cin i inh Phinh ddng mach chi hay hep

Xuathién sim bon bénvhan bam sinh

Ang mach ch voi da

ng dich Bénh van 2 [4

Sétthip

Hy) VALVULAACOMRPANIHON ETO BARAUNRHALTDS HDEARIT GEASEE PTAH SEDITIEON 2at

Nguyen nhian va am sang (2

Khing ph bién Akapto niu (idm Kho, tng Léng dongs tnd ay anh
homogenised)
Lupus (band, dau Khdp, bénh han) Day van va sbi

Kténg dK phot

Lymphoma Hodgkin Bénh macvhanh som

Ung thu vd Binh mang ngoa ti va bénh cot

ati tung tat Xo hth van vt van hát

Kh tu ching om Hi van dng ch

Vang dui dbng mach hay a xo oo Bat td bm si Kim (VSD, Cok

(bomusoua dae) PS)

Hi ching Wilans Thap be ml dng yeu tn
Dlg hop FH Bat hung lận
Kbémkhyét hg

Tuberous vanthomas

LOL$0 mgd

ey

Ue VAULAR HEART SEAGE ACKMPACNTORAANVA.S EAT SEAS FTHEDON at

Siu am | >La phuong tn quan tong nha

* Nguyén nfén

+ Ìll 46 nang

+ Tih tang huyét dng

+ Quyét inh dit
» Siu dm tn qua thénh nay

+ Ban du, theo di dink)

+ lận tiệt thíng ni
+ Thay 4 hoat dng thé cha

>Huyel 4p hi im

\VAVULAR HEART DSEASE:A COMPANION TO BRAUNWALOS HEART DISEASE, FIFTH EDITION, 2022

Siu am (2)

> Congenital bicupid aortic valve (usualy asymp:
tomatiunct midordlld eage),

> "Degeor cnalcearorticastetnosiis vsim ersk

factors s atherosclerosis oymptoms usually),

> Visual obserofviammtobiileoonrt valve plusa

valve are of less than 1.0 cmt define severe di

case; low-qradient but severe aortic tenosks can
thus be recognized when the stroke volume i

reduced,

*Eva Dp ans

> Surgery typically indicated fr symtoms, TAVR i

apprforopavtieentsdwith clic aortic stenosis,

CURRENT Medical Diagnosis &Treamn! SDTY-THRD EDITION, 224

Siu am (3}

» Siu dm tim qua thénh ngue: hinh thai hoc, ti

hoa
» Dign th mo: 20 hay 30

‘Han ché do bn lung va bé mat kdng du! 30

ida céng nhieu tl hep cdng ng

» MUic 6 hep

+\/m> a4 mxis, (AP>40 mig)hep nang

Vmax <3 mis, (AP < 20 mm) Q):hehpep nhe

PALVULAR HEAR DISEASE: A COMPANION TO BRAUNAL'S HEART DISEASE, FFTH EDITION, 2002

NI am (4

> Duong kith VOT, vong van DMC

» Vfan tte VOT (V4) PU

» Vax (V2): CW

› (hệ np dati mdt thi dm,

che h ap trung binh

> NVA

> Dimensionless index

> Kiel thud bubng hat tr, LVM

> HovanMC

> Bá h oi cdc van Kh

ASE COMPREHENSIVE ECHOCARDIOGRAPHY, THIRD EDITION, 2022

Mat ct doc that tr

Thelwall fitosa dashed ange) es between the anterior mil leaflet and

the postericousrp ofthe art valve and abus the floor of the transverse pericarda sinus (')

Nlou Fetal Functional Anatomy of Hoart HuTrhe Htearst thd, 07, MeGrawHl, 6100

Van MCcho th:ay 3 ménh van

Aorta

+ An opened aortic valve shows the night (R), ' Conus
lef), and posterior (P) cusps.

* The dashed line marks the closing ede.

Between the fee and closing edges of

each cusp are two lunular areas,
representing the suraoes of appostion

between acjacent cusps during valve

closure,

* The commissure () attain the level of fhe
aortic sinotubulrjncton (ST),

Nlou J Fatal FunoAtnatiomyoonftaHloart HurTshotHo’ut thd, 07, MoGran-Hil 6100

Hinh anh cdc la van hán nguyệt

Malou!) Fetal. Fungtonal Anatomy ofthe Heart Huss The Heat the, 217, McGraw 100

Hinthhai hoc an động mạch dủ

Normal lui Calle uy

Ny

Catherine otto The Practieof incl Echocardiography 6 Eaton, 2020

Mire d6 hep van dong mach chu

Aortic
Sclerosis Mild — Moderate Severe

Pw\Wltlll ó3 223 3H 240
Meanadent (ng) -
AVA on - j 1M
Ieved Alone) - M45 15 0
Veloty rato -
xIMŠ 60-085 <8
=H) 02-00 43

AVA A vale area

ASE COMPREHENSIVE ECHOCARDIOGRAPHY, THRO EDITION, 2022

During kinh budng tng tht tra VOT}

ASE'S COMPREHENSIVE ECHOCARDIOGRAPHY, THIRD EDITION, 2022

Dimensionless index (D!}

Mwor LVOT veloa(Vy1)
=—— Trans-aortic velocity (V max, V2)
Mls Time vloty integral (TV)

Heo nang Kh Di < 0.25

> Ty nig trong mot vi tn hugh sd ndy hôn

chinvahc

- Hep dud van ddng mach chi

Truc (Strut) cla van 2lé sinh hoc

ASE COMPREHENSIVE ECHOCARDIOGRAPHY, THRD EDITION, 2020

Do chenh ap qua van DMC

» PT Bemoull don glan :APmax= 4 Vmax}
› nhiêu cal ién APmax= 4 (Vmax? = VLVOT?) (V1 > 1.5

ms

YAP: 40-60 mmHq-A)S néng

»Chénh i mic 40 hep, te th nat bdp va cung lvong tim

(low stroke volume andlor cardac output)

Volume flow rate

+ fang tong AR, thieu mu thal ky... chénh ap tang mac du

hep ne

jan cheng ong, thủ. )¬3dÈtl

j qua van hap nhung h nang

ASE COMPREHENSIVE ECHOCARDIOGRAPHY, THRD EDITION, 2020