复旦大学：《儿科学》课程教学资源（PPT课件讲稿，双语版）Congenital Heart Diseases（CHD）先天性心脏病

Congenital Heart Diseases (cHD)先天性心脏病 复旦大学儿科医院

复旦大学儿科医院 Congenital Heart Diseases (CHD)先天性心脏病

Congenital Heart Diseases CHD先天性心脏病 General concept CHD occurs in approximately 6-8%o live births a In china. alone 250000 children with CHd are born each year a 30% of cases may die within first year of life The etiology remains unsolved Secondary prevention is the strategy at this stage

General concept ◼ CHD occurs in approximately 6-8‰ live births ◼ In China, alone 250000 children with CHD are born each year ◼ 30% of cases may die within first year of life ◼ The etiology remains unsolved ◼ Secondary prevention is the strategy at this stage Congenital Heart Diseases (CHD)先天性心脏病

Schematic Diagram of Cardiogenesis Bilaterally symmetrical cardiac progenitor cells form distinct regions of the heart The precardiac mesodermal cells give rise to a linear heart tube Forming a rightward loop Establishing the spatial orientation of the four-chambered mature heart

Schematic Diagram of Cardiogenesis ▪Bilaterally symmetrical cardiac progenitor cells form distinct regions of the heart ▪The precardiac mesodermal cells give rise to a linear heart tube ▪Forming a rightward loop ▪Establishing the spatial orientation of the four-chambered mature heart

Schematic Diagram of Cardiogenesis conotruncus AO 动脉干 RA主动脉肺动脉PA 动脉干 右心房 心室 动脉干 右心室 左心室 左心房LA → → 右心室 左心室 房 心房 右心室 左心室 心房 RV LV RV=right ventricle; LV=left ventricle; RA=right atrium Ao=aortic; LA-left atrium; PA-pulmonary artery

Schematic Diagram of Cardiogenesis RV LV LA PA conotruncus AO RV=right ventricle; LV=left ventricle; RA=right atrium Ao=aortic; LA=left atrium; PA=pulmonary artery RA

Fetal development One month 5th week 6th week 4星期 星期 期 8th week

Fetal development One month 5th week 6th week 8th week

Cardiac development Pericardium Bulbus ccrds Pericardial cavity atrium Bulboventricular Atrium Snus venosus A 0 Formation of a single Formation of the heart Heart tube loop

Cardiac development Formation of a single Heart tube Formation of the heart loop

Cardiac development 主动脉肺动脉 右心房 左心房 右心室 左心室 Out flow tract septation Septation of four chambers

Cardiac development Out flow tract septation Septation of four chambers

Ostium Septum primum Septum primum Osti primum Endocardial cushion Interventricul Atrioventricular canal B foramen Septum Septum secundum secundum secundum Septum Septum primum Ostium primum secundum Endocardial Endocardial Interventricular cushions fused cushion foramen Septum Venous Pulmonary secundum valves Septum primum up. vena cava Septum Valve of secundum foramen Valve of inf E Valve of coronary sinus Atrial sepration

原发房隔 原发孔 继发房隔 原发房隔 继发孔 继发房隔 Atrial septation

Molecular understanding of CHD CHD Gene Gene CHD 10%-15% may caused by single gene 85% may caused by polygenic disorders

Molecular understanding of CHD CHD Gene Gene CHD ◼ 10％－15％may caused by single gene ◼ 85％ may caused by polygenic disorders

Fetal and postnatal circulations 胎儿血循环与出生后改变

Fetal and postnatal circulations 胎儿血循环与出生后改变