Bài giảng Siêu âm tim 3D trong đánh giá và can thiệp các bệnh lý van tim - Nguyễn Thị Thu Hoài

SIấU ÂM TIM 3D TRONG ĐÁNH GIÁ VÀ CAN THIỆP CÁC BỆNH Lí VAN TIM TS.BS.NGUYỄN THỊ THU HOÀI VIỆN TIM MẠCH QUỐC GIA VIỆT NAM 4D echocardiography, history and actual performance. How to implement it to your routine echo lab 3D Echocardiography 2015: State of the Art TEE: AS diagnosis quantitative TTE: Pacemaker leads TTE and TEE: AC • LV Volume, Mass, radial, longitudinal, twist, torsion • AS TAVI, preinterventional, intra-, postprocedural, complications • MR differential diagnosis MitraClipđ, Cardioband đ, parav. leak • LAA preinterventional, intraprocedural • ASD preinterventional, intraprocedural • TR preinterventional, intraprocedural LỰA CHỌN VÀ ĐÁNH GIÁ BỆNH NHÂN KẸP SỬA VAN HAI LÁ QUA DA MITRACLIP - CẬP NHẬT VỀ VAI TRề CỦA SIấU ÂM TIM 3D QUA THỰC QUẢN 3D Select and assess patients for MitraClip: Update on the roles of 3D TEE Echocardiography is a key modality for MR Etiology Echo Severity Echo Symptom I nterviewing LV function Echo 2 Mitral Valve Anatomy l Leaflet l Annulus l Chordae l Papillary muscle MitraClip anatomical patient selection considerations Recommended criteria1 • Moderate to severe MR (Grade 3 or more out of 4 grades) • Pathology in A2-P2 area • Coaptation length > 2 mm (depending on leaflet mobility) FMR • Coaptation depth < 11 mm • Flail gap < 10 mm • Flail width < 15 mm • Mitral valve orifice area > 4cm2 (depending on leaflet mobility) • Mobile leaflet length > 1 cm DMR 1. The current patient considerations are based on EVEREST II and commercial European experience to date. The MitraClip Patient Selection Coniderations document has been endorsed by Expert Opinion (Crossroads institute). How to identify suitable patients? 1. Anatomic criteria. 2. Clinical criteria EVEREST II: need to select patients with potential clinical benefit.