Surgical Surgical Treatment of Treatment of Acquired Acquired Heart Heart DiseaseDisease 1.Rheumatic Heart Valve Disease1.Rheumatic Heart Valve Disease A.Mitral StenosisA.Mitral Stenosis B.Mitral RegurgitationB.Mitral Regurgitation C.Aortic StenosisC.Aortic Stenosis D.Aortic RegurgitationD.Aortic Regurgitation 2.Coronary Artery Disease2.Coronary Artery Disease 3.Chronic Constrictive 3.Chronic Constrictive PericarditisPericarditis 4.Cardiac Myxoma4.Cardiac Myxoma 5.Thoracic Aortic Aneurysm5.Thoracic Aortic AneurysmMitral StenosisMitral Stenosismost commonmost commonrheumatic feverrheumatic fever病理解剖病理解剖1 、隔膜型、隔膜型2 、隔膜漏斗型、隔膜漏斗型3 、漏斗型、漏斗型病理生理病理生理正常成人二尖瓣瓣口面积正常成人二尖瓣瓣口面积4-6cm4-6cm2＞2.5 cm2.5 cm2 2 轻微 轻微 1.5-2.5 cm1.5-2.5 cm2 2 轻度 轻度 1.0-1.5 cm1.0-1.5 cm2 2 中度 中度 ＜1.0 cm1.0 cm2 2 重度 重度 临床表现及诊断临床表现及诊断劳累性呼吸困难、心悸劳累性呼吸困难、心悸二尖瓣面容二尖瓣面容心尖区舒张中期滚筒样杂音（心尖区舒张中期滚筒样杂音（DM)DM)ECGECG 、x-rayx-ray 、彩色二维超声、彩色二维超声手术适应症手术适应症心功能心功能Ⅱ、Ⅲ级心功能心功能Ⅳ级: : 积极内科治疗、尽早手术积极内科治疗、尽早手术手术方法手术方法1 、闭式二尖瓣交界分离术（、闭式二尖瓣交界分离术（mitral commissurotomy) mitral commissurotomy) 经皮穿刺二尖瓣球囊扩张术经皮穿刺二尖瓣球囊扩张术 2 、二尖瓣成形术 、二尖瓣成形术 (mitral valvuloplasty)(mitral valvuloplasty) 3 、二尖瓣置换术、二尖瓣置换术(mitral valve replacement)(mitral valve replacement)二尖瓣置换术二尖瓣置换术清除左心房血栓清除左心房血栓切除病变瓣膜切除病变瓣膜置入人工心脏瓣膜置入人工心脏瓣膜人工心脏瓣膜人工心脏瓣膜机械瓣（机械瓣（mechanical valve)mechanical valve)生物瓣生物瓣(bioprosthetic valve)(bioprosthetic valve)Mitral RegurgitationMitral Regurgitation病因与病理解剖病因与病理解剖1.1. 风湿性疾病风湿性疾病2.2. 二尖瓣脱垂二尖瓣脱垂3.3. 缺血性心脏病缺血性心脏病4.4. 感染性...
