판막질환 총정리
MS | MR | AS | |
심잡음 | 심첨부 이완기(mid~late) | 심첨부 범수축기 | 흉골우연 2nd ICS 수축기(mid) |
AR | TS | TR | |
심잡음 | 흉골좌연 3rd ICS 확장기(early) | 흉골좌하연 확장기 | 흉골좌연 4th ICS 범수축기 |
침습적 치료 | ||||
분류 | MS | MR | AS | AR |
Severe | MVA ≤ 1.5 cm2 | ERO ≥ 0.4 cm2 | AVA ≤ 1 cm2 | ERO ≥ 0.3 cm2 |
RF ≥ 50% | Vmax ≥ 4 m/s | RF ≥ 50% | ||
Rvol ≥ 60 mL | ΔPmean ≥ 40 mmHg | Rvol ≥ 60 mL | ||
적응증 | 1. 유증상 severe | |||
2. 무증상 severe + 아래 | ||||
pHTN or new AF | LVEF ≤ 60% | LVEF < 50% | LVEF ≤ 55% | |
선택 | MVRp > MVR 1. PMBC 적응증 아님 | MVRp > MVR | SAVR 1. < 65세 2. 기저질환 없음/적음 | AVR |
PMBC 1. Calc/thickening X 2. MR none~mild 3. LA thrombus X | TAVI 1. > 80세 2. 기저질환 많음/심함 | |||
AF: Atrial fibrillation / AR: Aortic regurgitation / AS: Aortic stenosis / AVA: Aortic valve area / AVR: Aortic valve replacement / ΔPmean: Mean transvalvular gradient / ERO: Effective regurgitant orifice / LVEF: Left ventricular ejection fraction / MR: Mitral regurgitation / MS: Mitral stenosis MVA: Mitral valve area / MVR: Mitral valve replacement / MVRp: Mitral valve repair / pHTN: Pulmonary hypertension / PMBC: Percutaneous mitral balloon commissurotomy / RF: Regurgitant fraction / Rvol: Regurgitant volume / SAVR: Surgical aortic valve replacement / TAVI: Transcatheter aortic valve implantation / Vmax: Transvalvular maximum velocity
판막질환
폐동맥판 질환
심근 질환
확장심근병증