肥厚梗阻型心肌病的外科治疗.ppt

1、a,1,肥厚性梗阻型心肌病的外科治疗,刘晓程 泰达国际心血管病医院 2009-10-10,第二十届长城国际心脏病学会议 The 20th Great Wall International Congress of Cardiology (GW-ICC,a,2,常染色体显性遗传疾病 发病率1/500,a,3,a,4,a,5,1. Per the GeneTests Laboratory Directory 2. Allelic disorders = other phenotypes caused by mutation in the same gene 3. DCM = dilated card

2、iomyopathy 4. LGMD = limb-girdle muscular dystrophy 5. The consensus of the GeneReview authors is that additional confirmatory data supporting pathogenicity for this gene is necessary,a,6,A. 正常心脏B. HCMC. HCM （马森三色染色法,Images courtesy of Robert Padera, MD Brigham and Womens Hospital Department of Path

3、ology, Boston, MA.,组织学,a,7,症状 体征,动作或药物对HCM的影响,诊断,a,8,BrockenbroughBraunwaldMorrow 征,a,9,诊断：心电图,a,10,诊断：超声心动图,a,11,鉴别诊断,a,12,MRI,a,13,a,14,治疗策略,a,15,a,16,成功率,适应证,起搏器治疗,a,17,a,18,经皮室间隔消融术,a,19,a,20,外科治疗 HCM,a,21,a,22,经典Morrow术式,HCM的外科治疗,a,23,改良Morrow术式,a,24,HCM的外科治疗：患者资料,a,25,a,26,a,27,a,28,a,29,a,30,

4、a,31,a,32,a,33,a,34,两种术式的比较,a,35,谢谢,a,36,a,37,Surgery for Hypertrophic Cardiomyopathy (HCM,Xiaocheng Liu TEDA International Cardiovascular Hospital China 2009-10-10,第二十届长城国际心脏病学会议 The 20th Great Wall International Congress of Cardiology (GW-ICC,a,38,A autosomal dominant disease. Morbidity of HCM is

5、1 per 500,a,39,a,40,a,41,1. Per the GeneTests Laboratory Directory 2. Allelic disorders = other phenotypes caused by mutation in the same gene 3. DCM = dilated cardiomyopathy 4. LGMD = limb-girdle muscular dystrophy 5. The consensus of the GeneReview authors is that additional confirmatory data supp

6、orting pathogenicity for this gene is necessary,a,42,A. Normal heartB. HCMC. HCM with Masson trichrome staining,Images courtesy of Robert Padera, MD Brigham and Womens Hospital Department of Pathology, Boston, MA.,HISTOLOGY,a,43,symptoms signs,Effects of Physiologic and Pharmacologic Maneuvers on HC

7、M,DIAGNOSIS,a,44,BrockenbroughBraunwaldMorrow Sign,a,45,DIAGNOSIS: ECG,a,46,DIAGNOSIS: UCG,a,47,UCG for differential Diagnosis,a,48,MRI,a,49,a,50,Strategy of Treatment,a,51,a,52,Success rate,Indication,Pacemaker Therapy,a,53,a,54,Percutaneous septal ablation,a,55,a,56,Surgery for HCM,a,57,a,58,Classical Morrow Procedure,Surgery for HCM,a,59,Modified Morrow Procedure,a,60,Su