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M (MD):

M

M

A (AD)

A

A

A D?

M (MD):

M

M

A (AD)

A

A

A D?

H D

I ,

C

.

A

A

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The AORTIC ROOT has four anatomic components:

The aortic sinuses or sinuses of Valsalva

The aortic annulus or aortoventricular junction

The leaflets SINGLEFUNCTIONAL

UNIT

Aortic Root - Anatomy

The sinotubular junction

E

H D

-

M

Aortic Stenosis

()()

Aortic Stenosis

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H OCM (HOCM)

Aortic Stenosis

:

.

O2 /

:

:

L

2, 4

.

:

L

C

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:

:

LH LA

M

M

ECHO

A

E

?

0.12

A

A, ,

M A + CAD

B

A & L

No drugs alter course

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()

I

I

A

C

LE

, A D

A (, ; ; ;

C (M ; ; ED ; O ; ; A ; LE;)

H

B

Aortic regurgitation

Excess volume to the LV

LV end diastolic pressure

Stretching of Myocardium

wall stress

Eccentric LV hypertrophy

effective Stroke volume

Myocardial O2 demand(Ischemia)

LV failure

Myocardial O2 supply

(Ischemia)

M

A A L

. L . A ,

,

. A

, .

I ,

. D

.

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C A ; CHF

A . O A

:

; L

.

A .A ,

. A , . O ,

, L . L

.

A :

O ,

M

O L

(< 0.2% ), , L

D 60 H, 100 H. B C ("" ) A

M B ' H 40 H D ,

M ("" ) B

. . A 3 L

.

A D . A AF A. I , A. F

, M .

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) L

O , L

) CHF, ,

) A

F L L ECHO O

, :

( )

A

E :

L

L L

L .

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A (, , ). A

.

A . .

/ .

ECHO A E

M

A

() D : .

()

.

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C

C

E

C

,

I

C

(, F )

(, )

I

D

L .

C, .

E ,

M

F

L/

D

I

F

A

J.

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L

, , A

(C )

. ,

.

A , .

(.., ) .

,

.

.

.

:

,

.

() () .

A ,

.

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(10% )

, .

() , , .

F

, .

, .

.

M () .

.

I , , , .

.

, , .

A .

A .

A 1 2,

.

M , ,

.

E

N

.

.

: ECG

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M

B .

.

.

: , D .

E , , , , , .

O .

:

.

.

I . ()

: , ,

. C :

M: M ().

D M

I

C ).

C

J (J) .

.

(2) ,

, .

,

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("") .

.

()

CM .

.