主动脉 压合
Overview
主动脉缩窄是指部分主动脉变窄, the artery that sends oxygenated blood from the heart to the rest of the body. Many people with this condition will not have 症状 until later in life. 然而, 高血压会导致中风, congestive heart failure and complications of coronary artery disease.
当主动脉太窄时, it restricts blood flow to the lower part of the body and increases blood pressure above the narrowing. This means your heart has to work harder to circulate blood to the rest of the body. As a result of the increased work, the heart wall initially thickens, a condition called hypertrophy. 如果不纠正缩窄，可能会发展成心力衰竭. 充血性心力衰竭的症状之一是呼吸困难. 如果你生来就有主动脉缩窄, you may have other heart abnormalities such as deformed aortic valves, 动脉导管未闭或室间隔缺损.
High blood pressure above the narrowing also can result in high blood pressure in the arteries that branch out from the aorta, 包括手臂和大脑. 这可能会增加中风的风险.
在狭窄以下, the blood pressure may be too low and cause problems feeding enough blood into organs such as the kidneys.
主动脉缩窄的方法
UCSF提供全面的, highly specialized care for adults living with heart defects such as aortic coarctation. 我们专业的专家团队提供广泛的服务, 包括彻底的医疗评估, 先进的治疗, 长期监测, 以及个性化的饮食建议, 锻炼, 社会心理支持和计划生育.
这些天, we can often repair aortic coarctation using a minimally invasive procedure called cardiac catheterization. 在这个过程中, 十大赌博平台排行榜插入一根细针, 挠性管, 叫做导管, through a small incision in the groin and gently guides it through the blood vessels up to the heart. The physician uses instruments at the end of the catheter to widen the narrowed portion of the aorta and place a stent, 可膨胀的金属管, 在支持它的领域. 心导管检查 provides complete repair of the narrowed aorta for more than 98 percent of patients.
奖 & 识别
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是全国顶尖的十大赌博平台排行榜之一
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全国最好的心脏病和心脏专家之一 & 血管手术
迹象 & 症状
主动脉缩窄的症状包括:
- 用力呼吸困难，称为用力性呼吸困难
- 头痛
- 鼻出血，称为鼻出血
- 腿部疲劳和抽筋
在30岁以下未经治疗的患者中, aortic rupture and cerebral hemorrhage are the most common complications. After age 40, the incidence of congestive heart failure increases.
诊断
如果一个人出生时没有严重的症状, 主动脉缩窄可能直到成年后才被发现. It is most commonly discovered in adults between the ages of 15 and 40, often because the doctor notices a heart murmur in a patient with high blood pressure. 很少, a patient may come for emergency treatment because of aortic rupture, 感染或脑出血.
确定是否存在缩窄的测试包括:
- Blood pressure is checked to see whether there is lower blood pressure or reduced pulse in the legs compared to the arms
- Electrocardiogram (EKG or ECG), which records the heart's electrical activity
- 胸部x光检查心脏大小
- 超声心动图，这是一种对心脏的超声检查
- 磁共振成像(MRI)产生心脏的图像
除了, your doctor may use a cardiac catheterization procedure to inject a dye into the heart and to see on a moving picture X-ray how the heart and aorta are functioning.
治疗
在过去, coarctation repair always involved heart surgery through an incision in the side of the chest that required five to seven days in the hospital for recovery. Now it is often possible to correct coarctation without surgery in a procedure called a cardiac catheterization.
心导管检查
心导管插入术包括放置一个长, 薄, 中空塑料管, 叫做导管, into the blood vessel in the groin and passing it through vessels into the heart's chambers. 导管是用来采集血样的, 测量压力，为x光片注入染料. Modern imaging technology allows doctors to see where the catheter is going and how the heart is functioning.
The diameter at the site of aortic narrowing is measured so that the proper size stent, 一种可膨胀的开槽金属管, 可以选择. Sometimes, more than one stent will be needed for complete repair. If the narrowing is too close to the head and neck vessels, stent repair may not be possible. Surgical repair would then be necessary and would be scheduled for another time.
在选择合适的支架后, 它被放置在导管尖端的一个放气的气球上. When the balloon reaches the site of the narrowing, it is expanded to widen the artery. The stent is left in place to support the newly widened artery walls and the catheter and balloon are withdrawn.
The procedure is safe and effective with immediate complete repair in over 98 percent of patients. Complications during the procedure are rare and almost all can be treated immediately. 其中包括需要输血的失血, 对x射线染料过敏，需要药物治疗, aneurysm and improper stent position requiring retrieval by catheter or surgery. There is a small risk of blockage of the groin vessels used for catheterization, 哪一种通常对药物有反应. 手术后并发症, 比如破碎, 支架移动或感染, 是极其罕见的，在不到1%的患者中发生吗. In less than 5 percent of patients, an aneurysm or widening at the stent site may develop.
The catheterization and stent placement take approximately three to four hours. 病人 are admitted to the hospital the morning of the procedure and discharged the following morning. 最常, 患者接受阻断血小板功能的药物治疗, 比如氯吡格雷, 手术后的一段时间.
After treatment, follow-up will be necessary for the rest of your life. This will include taking antibiotics before dental or surgical procedures, regular magnetic resonance imaging (MRI) exams and perhaps subsequent surgery. Women should consult with a cardiologist before becoming pregnant to determine any risk factors.
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
