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VALVULOPATII VALVULOPATII MITRALE & AORTICEMITRALE & AORTICE
Antoniu Petris MD, PhD, FESCAntoniu Petris MD, PhD, FESC
“St. Spiridon” Hospital Iasi, Romania““St. St. SpiridonSpiridon”” Hospital Iasi, RomaniaHospital Iasi, Romania
UMF “Gr. T. Popa” Iasi, RomaniaUMF UMF ““Gr. T. Gr. T. PopaPopa”” Iasi, RomaniaIasi, Romania
© Toate drepturile rezervate dr. Antoniu Petris
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44--6 cm6 cm22
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Valva aotica normala inchisa - deschisa
22--3 cm3 cm22
Sutton GC, Chatterjee K, 1998Sutton GC, Chatterjee K, 1998
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STENOZA MITRALA
INSUFICIENTA MITRALA
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STENOZA AORTICA
INSUFICIENTA AORTICA
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STENOZA MITRALA
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AglutinareAglutinare sisifibrozarefibrozare
cordajecordaje 15%15%
FuziuneFuziunecuspecuspe 15%15%
IngrosareIngrosare sisifuziunefuziune comisuricomisuri
30%30%
+ + combinatiicombinatii 40%40%
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“gura de peste”““guragura de de pestepeste””
StenozaStenoza mitralamitralaBinottoBinotto MA et al. Images in MA et al. Images in PaedrieticPaedrietic CardiolCardiol 2002; 11: 122002; 11: 12--3131
Stenotic mitral valve seen from left atrium. Both commissuresare fused; the cusps are severely thickened. The left atrium is huge. The valve is both incompetent and stenotic.
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StenozaStenoza mitralamitralaBinottoBinotto MA et al. Images in MA et al. Images in PaedrieticPaedrietic CardiolCardiol 2002; 11: 122002; 11: 12--3131
Opened stenotic mitral valve showing thickening distorted cusps, adherent commissures with calcification and thrombus deposition, and thickening, fusion and shortening of chordaetendinae.
Opened stenotic mitral valve showing thickening distorted cusps, adherent commissures with calcification and thrombus deposition, and thickening, fusion and shortening of chordaetendinae.
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B:F = 1:2
Din valvulopatiile reumatice:
25% stenoze mitrale puse
40% boala mitrala (SM + IM)
< 2 cm2 – gradient AS-VS doar la efort (SM larga)
1.5-2 cm2 gradient VS-AS in tahicardie (SM moderata)
1-1.5 cm2 - gradient permanent (SM moderata)
< 1 cm2 – gradient critic = 20 mmHg si PAS > 25 mmHg si PCP > 20-25 mmHg (SM severa)
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Examen radiologic – cord configurat mitral prin hipertrofia şi dilatarea atriilor şi ventriculului drept; stază pulmonară până la aspect de edem pulmonar
Examen radiologic – cord configurat mitral prin hipertrofia şi dilatarea atriilor şi ventriculului drept; stază pulmonară până la aspect de edem pulmonar
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INSUFICIENTA MITRALA
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Stenoza mitrala Insuficienta mitrala
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STENOZA AORTICA
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Stenoza aortica reumatismala sisenoza aortica senila
Sutton GC, Chatterjee K, 1998Sutton GC, Chatterjee K, 1998
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Valva aortica bicuspida calcificata
Sutton GC, Chatterjee K, 1998Sutton GC, Chatterjee K, 1998
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http://cueflash.com/decks/Cardiovasc_Path
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DilatareDilatare postpost--stenoticastenoticaa a aorteiaortei ascendenteascendente
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INSUFICIENTA AORTICA
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http://wikidoc.org/index.php/Aortic_Regurgitation_Chest_x-ray
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