Cov kab mob plawv li qub
Kab mob plawv Valvular
1. Congenital: congenital defect
2 、 Tom ntej:
1) Kab mob Rheumatic
Qhov laj thawj tseem ceeb
Mitral stenosis / Mitral incompetence
Aortic senosis / Aortic incompetence
Prolapse ntawm mitral
2) Tsis-rheumatic mob plawv
Xws li cov neeg laus mob ntev ischemia ; Kab mob plawv mob myocardial infarction ; mob hnyav ; kab mob ntawm lub valve
Disadvantages ntawm tsoos valve hloov kab
-Lub transverse tswj quab yuam ntawm lub suture nws tus kheej nyob rau hauv daim ntawv cog lus yog qhov pib xoom.
-Cov lus cog tseg muaj cov lus qhia zoo thiab tsis zoo
- Lub suture twine yooj yim
-Cov lus cog tseg overturns yooj yim
-Qhov kev cog lus yog mos, thiab nws yooj yim rau compress thiab deform thaum knotting. Tom qab stitching thiab knotting, ob qhov kawg ntawm lub gasket yog upwarped thiab tsis tuaj yeem ntxiv dag zog
Tshiab hom anti-entanglement valve sutures
● Kev cog lus tsis muaj kev taw qhia: Tsis tas yuav kho qhov kev cog lus tshwj xeeb
●Suture tsis muaj twining
● Ntau qhov tsim nyog rau tus kws phais kom muaj kev ua haujlwm zoo dua
● Tsim nyog rau kev hloov lub plawv nres tsawg kawg nkaus
Main aortic valve hloov phais Cov kauj ruam tshwj xeeb:
1. Kev phais thiab kev tsim ntawm cov hlab ntsha extracorporeal
2. Aortic incision. Tom qab kev ua haujlwm ntawm lub plawv dhia, thaum qhov kub thiab txias poob mus rau 30 ℃, lub ascending aorta raug thaiv, thiab txias cardioplegia tau infused, thaum lub plawv txias tau ua. Tom qab lub plawv nres, ib qho transverse lossis oblique aortic incision tau ua, thiab qhov qis kawg ntawm qhov kev txiav yog li 1-1.5cm los ntawm qhov qhib ntawm txoj hlab ntsha sab xis.Lub sab laug thiab sab xis coronary hlab ntsha qhib tau pom kom paub meej tias qhov xav tau valve. hloov kho rau tus kab mob aortic valve
3. Ib txoj kab traction yog sutured ntawm txhua qhov ntawm peb junctions ntawm lub aortic valve.
4. Tshem tawm ntawm lub valve Peb lobes raug tshem tawm nyias, tawm hauv 2 hli ntawm ntug. Tom qab ntawd cov ntaub so ntswg calcified ntawm lub nplhaib raug tshem tawm. Lub nplhaib tau ntsuas nrog lub ntsuas valve los txiav txim seb tus naj npawb ntawm cov pob qij txha
5.Suture Lub 2-0 polyester hloov xov yog siv rau cov ntaub so ntswg suture los ntawm sab saum toj mus rau hauv qab. Tom qab lub nplhaib tau sewn, cov kab suture yuav tsum tau muab sib npaug thiab sib npaug ntawm lub nplhaib thiab lub plawv li qub. Qhov deb ntawm rab koob feem ntau yog 2 hli
6. implantation Tag nrho cov sutures tau straighened thiab cov khoom siv lub valve raug thawb hauv qab lub nplhaib valve kom paub meej tias cov implantation nyob rau hauv qhov chaw thiab tias cov khoom siv valve tsis cuam tshuam rau sab laug thiab sab xis coronary qhib. Ces lub pob caus tau khi ib tug los ntawm ib tug. Qhov kev ntsuam xyuas zaum kawg tau lees paub tias sab laug thiab sab xis ntawm txoj hlab ntshav tau pom tseeb
7.Kev ntxuav kom huv si yaug lub aorta thiab sab laug ventricle saum toj thiab hauv qab ntawm lub pob qij txha thiab sau lub aorta thiab sab laug ventricle nrog saline ib txwm.
8.Suturing Siv 4-0 los yog 5-0 polypropylene rau suture, Ob tug aortic incisions tau sutured consecutively. Venting yuav tsum tau ua ua ntej lub xeem stitch tau nruj.
Aortic valve hloov suture- Polyester, polyester nrog kev cog lus, Polypropylene
