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X ray

PA. X ray. Pulmonary congestion Cardiomegaly Prominent PA Enlarged RA/ Rv. ECG. Right axis deviation RV hypertrophy. 心电图. Incomplete Right bundle branch block ： V1 rsR ` QRS < 0.12sec. Echo. Catheterization. pressure RV PA Oxygen saturation CV 1 RA 2 RV 3 PA 4. 1.

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X ray

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  1. PA X ray Pulmonary congestion Cardiomegaly Prominent PA Enlarged RA/Rv

  2. ECG Right axis deviation RV hypertrophy

  3. 心电图 Incomplete Right bundle branch block： V1rsR` QRS < 0.12sec

  4. Echo

  5. Catheterization pressure RV PA Oxygen saturation CV 1 RA2 RV3 PA4 1 4 2 3

  6. Angiography Anomalous pathway interatrial

  7. Treatments Surgery: 4~5y/r Intervention is recommended as the first choice in many cases： needs： the site of defect the margin of the defect

  8. Intervention of ASD

  9. Intervention of ASD

  10. Intervention of ASD

  11. Intervention of ASD

  12. Intervention of ASD

  13. Introduction AtrialSeptal Defects Ventricular Septal Defects Patent DuctusArteriosus Tetralogyof Fallot Pulmonary Stenosis

  14. Ventricular Septal Defect

  15. Phathological classification The ventricular septum is divided into : a small membranous portion a large muscular portion the inlet septum the trabecular septum the outlet septum

  16. Phathological classification Membranous defect： most common 70%

  17. Phathological classification Infundibular defect： About 5~7%

  18. Phathological classification Muscular defect： About 13~15%

  19. Size classification Nonrestrictive VSD

  20. Hemodynamic Features : CV RA RV PA LA LV Ao Pulmonary Circulation

  21. Hemodynamic Features : CV RA RV PA LA LV Ao Pulmonary Circulation

  22. Clinical Manfestations small：asymptomatic，Roger disease moderate to large： delayed growth and development decreased exercise tolerance repeated pneumonia CHF

  23. Clinical Manfestations Automatic closure occurs in about 20% cases within 2 y/r A few cases have aortic insufficiency Large VSDs suffer from Eisenmenger Syndrome in earlier stage Infectious endocarditis: a main complication

  24. Physical Examination Increased P2 intensity Grade 3-6 SM is audible at 3-4 left sternal border Systolic thrill Enlarged cardiac border 心尖区闻及DM

  25. Infectious endocarditis

  26. X ray • Pulmonary congestion • cardiomegaly • Prominent pulmonary marking • Enlarged LV RV • Enlarged LA

  27. ECG small： LV hypertrophy large： ventricular hypertrophy Depressed ST-T

  28. Echo

  29. Echo

  30. Catheterization pressure RV PA Oxygen saturation CV 1 RA2 RV3 PA4 1 4 2 3

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