Những vấn đề mới trong lượng giá hở van ba lá

NHUNG VAN BE OI TRONG

LUONGIAHO VAN BALA

TS. Trinh Viét Ha

Vin tim mach Viet Nam

Hy gu NI

ITY OF ULTRASIONUNMDi
_ sốni vn amp it

MO DAU

+7) HOBL ting theo tu, ong 08% cm6eho va

den nang,

+T) KE HOBL nang @ nt cao gp 4,3 an nam gi

‘Khoang 30-40‘h BN HOHL kém theo HOBL

:Bịnh thân HÚBL từa tà mng c in ong ti hon,
“Ho van ba lénhe cing cOlién quan dnt le t-vong do

Moi Vi nhân tắn gan 30%,

Sigh lal An Cl Oana
Toy Yea AC Cras nag 201912918040

NOIDUNG

«Dac did gil phdu van bal

"Nguyén nin ho van ba l

* Luong gid mic 46 ho van ba l

Taglhgtin

te |Pri TR
See
(Suge ad) (Ge)

Ry ot foe = mm Nit ụ mt §
(Se) sid vive sey HOBL
(Ste)
~Daginthrigu
mm.
ch (va vat

wide rit = oe — ola du ti ni
wgey progres Mjm

=f=o “ts pet sia| nguyén

ma nhin HoBL

| | «Dinh longli

Jou itn] Hee thvua dchute

va | Ra rng tt phi

fom || thưa «Kae inh micd6

nang cia tang ép

phi

CttoCM etal JAm Coll carlol 2021 Feb 2:74)460.400

Hinh tha van ba va that hal

Vena phat va gn
mom hat

*Lav'a satu uvan dba ephy

luật tài nhútưnới gan

tà? tình tuớc -lêt ái tải

+ |4 tứch (lá ướt đIt tử

vt in ht thing qua dy

chang gan Và) cử vung vach

beep lvao wat ch lên tat

Dahow Act al. JAm Cardiol Img 2019:12: 458-68

Hinh thái tan la lá tiện siêu âm 3Ì
thành) It

Patrizio Lancelot! furopeon Heot Journal -Cordiovosclor Imaging (2022) 23, 171-2232

Proposal fora Standard Echocardlographic

Tricuspid Valve Nomenclature

Rebeca Ha, MDL, Wecbch, MD, Tio Noack, MD, Pi) Nadia Hamil, MD)

CENTRAL ILLUSTRATION Trkwpl Vale Komndabe Caan tame

A oA
aN §

,thooA ị tA Wel ht Wp
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hi
mm!hy |
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ed J Cl Grd ig A

HaRhT netal JACC Cardlovase Ima2g02i1 Jnu g 14(7):1200-1305

Giiphduvong van ba

A. Ving van tint ch bao gm ng vch gn png va ving rudlsau

(0l

ÿ. Miềuyhằntit0 ‘cs crossing mbit) ty bp vo phn dy cla

vant) hatphd

C. Vbng van’ (nbitn rng) hing o dang sv b chunip ton tu

ttm nim

+ Hinh dng yén xe
+ Thaydion 20% ve cig icc vidvéng kn ton chu) tin

Dahow Atal. |Am Col Cadi! Img 2019; 12456468

Phan loai nguyen nhan ho van be la

+ yên phát
(0%): dob thud van Al SEAL aeet ed
«May ao hip r
+ Xo hoa nol mac
«Chan thuong
Thatim
«Banh ty min

«Sala van

Phan loai nuên niên hử van bea

* HOBL thi phat (co-nang) (80-857); la van hinh thai binh thuomg,
«Rung oh
+ Benn van ti tra

Tang ap dng mach phi

-Riloan cite ming tm ph

“Kodi

«Anh hung ia dy dn may tao nip im (10)

in nhàn: va cham vao van thing, hog th hột lạn thứ
van lát dui van,

nbn: sign cin cla CIED ma Khdng anh hudng dén b6 may

Ho ba tpt

+ Ha th phat do én la tht
«Tang ap phi sau mao mach do bénh that ri HFEF

hoa HFEF) hodc bénh van tim tral

-TAP ttn mao mach do bgnh dng mach phi nguyén ph

hofe bénh nf md piv dy Téng dp phi nh phd mn

tinh hoa CTEPH)

-ROiloan cht nng tht ph ngyén phat ho fic

tric (do nhoi mau that phal hod bénh co tim tht pha

+ Hor bal thie phat do bénh I cla ni

Glin nti ph hay vong van ba (én quan dén tub, rung

nhi hay HFEF)

Dac diem im sang, lỊtltúi àuyếtđộng tỉa

ho’van bal thie phat tm nh va tam that

li or en em ‘ohn ml
wal mal AON) anid0h)
(akin btn
Nalin fe se)
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Noni
hdr

Apel dant dtc
Aart dren

‘Aly type

pei ton

Hahn REN Eng) Med 2028 36:16 1.

Atrial and Ventricular Secondary Triscupid Regurgitation

\ onal tr ‘ ‘AtaTlR: orig eight $40 mm and dence’ Canela $98 mm and LVEF 260%

NoaTR: al chs wth opr erty ha and RV cerca Gamelan LI. EF

dofinoad; N= 64 pls with Woelemles Wht
4ipiftarR ) qu
Haouuuynhài
parched oes if
mm
TR
Niveih nerie

dlameler<38 mm

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th
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Schltr, etal Cire Cardiovas Interv, 2022 Sep; 16(9}:011968

Đính đi trút do a bali

(Mu updqrgtlet0ugMl Edoadugih

Zoghbl Wael Am Soe Ethocard2o01g7, 30:90237
AM di EurHoat JCardovas magn: 202A2pt 1829() 1714282

Hanh gid mle do nang cua Ho ba

TASeveiy clases Mid ÂM

uate pooner Noval ly abomiaelts Mabatlbomllulu - $weeohtlelwdhllrgtmp

‘Trvkalveumoprphdology tation defectsover tenting

Colu fow Ret Sol ro, cen oder cna Large central to ecevicwal

Flow comrpecoere Ihyjtfwiltit

CW sl of TRet Neti tre rm — lienelithitoadldrlei Large throughoutote

Sent one Fault Cansfabol, rag Denselftn ranula with early

Havin to peaking (ek nin mage TR)

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HO)

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AV RA NC sae? sul noma Nora of md dation uly lated

Lancoll Poll Eur Heat J Crdvmaasg: 202A2pt 182() 0714282

Danh oid mirc dO néng cla Ho ba la

Table16 Grading the severity of TR in the context of transcatheter TV repatireplacement

Severe Massive Terentia

Sem quantatve parameters

VC with (nm) M3 Ve) 1

XD VCarea or qunttatve Doplr EROA (mì l9 #-I XI

(luntltlltprandws 4 60-1) 3

EROALy SA (nt)

RVol (ml) 9g 14 BH

EROA, fective rp rficeare RE, ugar action Vo reurptant vole,

'MiNtintdWHÍmi.

Eine Nyt insti of ens

Lancelot, etal Eur Hea J CardlovaseInaging: 2020 A1p623/5) e1712032

Do din tich dong ho’ ba a

LNyquistlimitS0-0cm)s Uw dm: dé do

R !hược in:

Phu thude vao ap luc tng mau va

hướn dong chay

“Huong va hinh dang cua dong

ho cb thé dégniahqué mic HOBL

(rung tm) hoa dn ga thép

a din tich dong ho (ho lc tém, va

vao thanthi)

«nh gi qu cao ki HoBL Kg

toan thi tém thu

RebeccaT. Hahn JCC: CARDIOVASCULAR IMAGING, VOL. 12, NO. 3, 2019

Han ché cia din ich dong ho

* “Van ba a ho nang cothhe co van the dongchay th ap ma khong ¢6
dng i hod Kham mau dan gid mire 4 bo bang Dopplr mau

Kho khan”

+Dientich dong ho khong duc dinh lvong mic db nang cua

HOBL

+Hinh anh dong mau CH ượ sử dụng đ chân don sign cn

ca HOBL

+ Can dnt wong mie db HOBL khi quan sé duoc niéu hon mat

dong HOBL trung lân.

LanoelotiP, etal. Eur latJ Cardlovase Imaging: 202A2pr 16,23(5) 71-0282

Định gia mu do HOBL su dung do
rong Vena Contracta

lu j : A, Dé gd HOBL bang do db
Tc)
rong ding hd (VC with) gbm3

than phn cla ding ho ving
htt cng mau, cho hep nat

tt j

B, Hinh an 3D cua dong ho

LanoelotiP, etal. Eur latJ Cardlovase Imaging: 202A2pr 16,23(5) 71-0282

Han ché cla Vena Contracta

+Khuyén cdo hig tai do VC27 mm duo dn gi la

nang
'TrmnJnhững tường hựp hửba cb nbiu dng hi, i

tỉa tít độ lừa lá Khơ duoc cong gop

«Nb do tip mat ct 4 budng tổ là lích thước vách và lớn

tà đánh ld tp i

Zoghti WAC ald Am Soc Echocar20g17; 3139947