重庆医科大学：《儿科学》课程教学资源（PPT课件）Congenital Heart Disease

Congenital Heart Disease Jie Tian MD Children's Hospital of CUMs STAI

Congenital Heart Disease Jie Tian M.D. Children’s Hospital of CUMS

Left common carotid artery A Brachiocephalic arter Left subclavian artery Left brachiocephalic vei Superior vena cava Aortic arch Superior vena cava Pul monary trunk Right Left ght auricLe atrium Right ventricular outflow track Left ventricular outflow track Left ventricle vena cava Right ventricle Apex of heart

Left common carotid artery A Left subclavian artery Left brachiocephalic vei Superior vena cava Aortic arch Superior ve Pul monary trunk Pa monar Left Left coronary Lauric arte atrium Aortic Left Right coronary artery circumflex artery Left anteri descend ng artery Tricuspid Papillary Left ventricle vena cava Right ventricle Apex of heart Posterior descend ng artery

Anterior cusp Right cusp L. brachiocephalic vein Brachiocephalic art Left cusp Right atrium L. common rotid art Aortic valve Left cusp Right cusp L subclavian Posterior cusp Pul monia Mitral yalve Pulmonary Aortic arch Anterior(aortic)cusp ght entricle Posterior v R pul monary art valve Chordae Mitral L. pul monary art Posterior papillary muscle nterior papillary muscle Left tendi neae Left pul monary veins Note: the tricuspid valve Papillary muscles Left atrium is not shown in this view Coronary sinus

Brachiocephalic artery Brachiocephalic arter L common carotid artery common carotid artery L subclavian artery vena cava L: brachiocephalic vein brachiocephalic vein Aortic arch Pulmonary trunk Pul monary trunk cendi ng aorta Left pulomonary artery Pul monic valve artic val Left atrium atrium Mitral Aortic valve Mitral valve ventricle sInUs Interventricular Tricuspid Anterior papillary mus Ive Chordae tendi neae Posterior papillary uscle Right ventricle Left ventricle

Apex of lung Thyroid cartilage Clavicle Thyroid gland Coracoid proces Acromion Trachea Manubrium 3 Humerus Right border of the heart 4 terTium Border of left A×iarg ventricle fold 5 6 Dome of diaphragm Xiphoid cartilage Pleural reflection Infrasternal angle Costal arch

Aortic arch uperior wena cava Mediastinal nodes Ascendi ng aorta . St cardiac plexus L recurrent Rir ight pul monary artery laryngeal nerve Pulmonary trunk Left pul monary vein Right pul monary vein Left plumonary artery pericardiacophrenic art. Horizontal fissure Aortic valve Right coronary artery Left anterior descend ng Right atrium coronary artery Left inferior bronchus Right inferior pulmonary vein Mitral valve Tricuspid valve Chordae tendi neae Right ventricle la of Jeft lur Right dome Apex of the heart ot diaphragm Left dome of diaphragm

Epidemiology of Chd 豢 Preva|ence CHD occurs in0.5-0.8% of live births The incidence is higher among stillborns 死产(3-4%), abortuses流产(10-25%),and premature infants(about 2% excluding PDA) about 2-3 in 1.000 newborn infants will be symptomatic with heart disease in the first year of life

Epidemiology of CHD  Prevalence  CHD occurs in 0.5-0.8% of live births;  The incidence is higher among stillborns 死产(3-4%), abortuses流产(10-25%), and premature infants (about 2% excluding PDA);  About 2-3 in 1,000 newborn infants will be symptomatic with heart disease in the first year of life

Epidemiology of Chd w Prevalence he diagnosis is established by 1 week of age in 40-50% of patients with CHD and by 1 month of age in 50-60% patients With the advances in both palliative姑息 and corrective surgery of the last 20 years the number of children with CHD surviving to adulthood has increased dramatically

Epidemiology of CHD  Prevalence  The diagnosis is established by 1 week of age in 40-50% of patients with CHD and by 1 month of age in 50-60% patients;  With the advances in both palliative姑息 and corrective surgery of the last 20 years, the number of children with CHD surviving to adulthood has increased dramatically;

Epidemiology of Chd w Prevalence Despite these advances, CHD remains the leading cause of death in children with congenItal malformations Most congenital defects are well tolerated in the fetus because of the parallel nature of the fetal circulation

Epidemiology of CHD  Prevalence  Despite these advances, CHD remains the leading cause of death in children with congenital malformations;  Most congenital defects are well tolerated in the fetus because of the parallel nature of the fetal circulation