主动脉 压合
Overview
主动脉 coarctation is a narrowing of part of the aorta, 将含氧血液从心脏输送到身体其他部位的动脉. 许多患有这种疾病的人直到晚年才会出现症状. 然而, it can lead to hypertension resulting in stroke, 充血性心力衰竭和冠状动脉疾病的并发症.
When the aorta is too narrow, 它会限制血液流向身体的下半部分，并使狭窄部位上方的血压升高. 这意味着你的心脏必须更加努力地将血液循环到身体的其他部位. 由于工作增加，心脏壁开始增厚，这种情况称为肥厚. If the coarctation is not corrected, heart failure may develop. One of the 症状 of congestive heart failure is breathlessness. If you were born with aortic coarctation, 你可能有其他心脏异常，比如主动脉瓣畸形, patent ductus arteriosus or ventricular septal defect.
血管狭窄上方的高血压也会导致主动脉分支动脉的高血压, including those in the arms and brain. This may increase the risk of a stroke.
Below the narrowing, 血压过低可能会导致肾脏等器官供血不足.
Our approach to aortic coarctation
UCSF provides comprehensive, 为患有心脏缺陷的成人提供高度专业化的护理，如主动脉缩窄. Our dedicated team of experts offers a wide array of services, including thorough medical evaluations, advanced treatments, long-term monitoring, and personalized recommendations on diet, 锻炼, psychosocial support and family planning.
这些天, 我们通常可以用一种叫做心导管置入术的微创手术来修复主动脉缩窄. During this procedure, the physician inserts a 薄, 挠性管, called a catheter, 通过腹股沟上的一个小切口轻轻地引导它穿过血管到达心脏. 十大赌博平台排行榜使用导管末端的器械扩大狭窄的主动脉并放置支架, an expandable metal tube, in the area to support it. 心导管为98%以上的患者提供了狭窄主动脉的完全修复.
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One of the nation's best in cardiology and heart & vascular surgery
迹象 & 症状
Symptoms of aortic coarctation include:
- Difficulty brea薄g with exertion, called exertional dyspnea
- 头痛
- Nose bleeds, called epistaxis
- Leg fatigue and cramps
In untreated patients younger than 30 years old, 主动脉破裂和脑出血是最常见的并发症. After age 40, the incidence of congestive heart failure increases.
诊断
If a person doesn't have severe 症状 at birth, the aortic coarctation may go unnoticed until adulthood. 它最常见于15至40岁的成年人, 通常是因为十大赌博平台排行榜注意到高血压患者有心脏杂音. 很少, 病人可能因为主动脉破裂而来接受紧急治疗, infection or cerebral bleeding.
Tests to determine whether a coarctation is present include:
- 检查血压，看与手臂相比，腿部是否有较低的血压或脉搏减少
- 记录心脏电活动的心电图(EKG或ECG)
- Chest X-ray to see the heart's size
- Echocardiogram, which is an ultrasound examination of the heart
- Magnetic resonance imaging (MRI) to produce pictures of the heart
除了, 你的十大赌博平台排行榜可能会使用心导管手术将一种染料注入心脏，并通过移动的x光片观察心脏和主动脉的功能.
治疗
在过去, 缩窄修复通常需要通过胸部一侧的切口进行心脏手术，需要住院5到7天才能恢复. 现在，通常可以不通过手术纠正心导管狭窄，这一过程被称为心导管插入术.
Cardiac catheterization
The heart catheterization consists of placing a long, 薄, hollow plastic tube, called a catheter, 进入腹股沟的血管并通过血管进入心脏腔室. The catheter is used to gather blood samples, take pressure measurements and inject dye for X-ray movies. 现代成像技术使十大赌博平台排行榜能够看到导管的去向和心脏的功能.
测量主动脉狭窄部位的直径，以确定合适的支架尺寸, an expandable slotted metal tube, can be selected. Sometimes, more than one stent will be needed for complete repair. 如果狭窄太靠近头颈部血管，支架修复可能是不可能的. 手术修复将是必要的，并将安排在另一个时间.
After an appropriate stent has been selected, it is placed over a deflated balloon at the catheter's tip. 当球囊到达狭窄的部位时，它被扩张以扩大动脉. 将支架留在原位以支持新拓宽的动脉壁，取出导管和球囊.
该手术安全有效，98%以上的患者可立即完全修复. 手术过程中的并发症是罕见的，几乎所有可以立即治疗. These include blood loss requiring a transfusion, allergic reaction to X-ray dye requiring medication, 动脉瘤和不合适的支架位置需要导管或手术取出. 用于导管置入的腹股沟血管有堵塞的小风险, which ordinarily responds to medication. Complications after the procedure, such as breakage, movement or infection of the stent, are extremely rare and occur in less than 1 percent of patients. 在不到5%的患者中，动脉瘤或支架部位的扩张可能会发展.
导管置入和支架置入大约需要三到四个小时. 患者在手术当天早上入院，第二天早上出院. 最常, patients are treated with a drug that blocks platelet function, such as clopidigrel, for a period of time after the procedure.
治疗后，在你的余生中，随访是必要的. 这包括在牙科或外科手术前服用抗生素, 定期核磁共振成像(MRI)检查和可能的后续手术. 女性应该在怀孕前咨询心脏病专家，以确定任何风险因素.
加州大学旧金山分校健康 medical specialists have reviewed this information. 它仅用于教育目的，并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.
