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MACH PHOI
(Anomaly of pulmonary venous
connection)
PGS.TS PHAM NGUYEN VINH
VIEN TIM TP HO CH MINH
A. NLBT TMP vao TMC tren. The nay thng co TLN kieu
xoang tnh mach
B. NLBT TMP vao TMC di. Phoi phai thng c dan mau 3
bang 1 TMP bat thng.Thng co bat thng nhu mo
SV: TM lach
RH:
A. Mang splanchnic dan mau phoi tao thanh mang mach mau
phoi. Mang nay khong thong thng vi tim ma noi vi
TM cardinal va TM umbilico vitelline
B. TMP chung bat nguon t nh trai, thong thng vi mang
splanchnic. Do o mau TMP thong thng vi nh trai
C. S noi lien gia mang mach mau phoi vi TM cardinal va
TM umbilico- vitelline khong can na nen bien mat
D. S phat trien cua nh trai, giup TMP chung hoa nhap vao.
10
Do o tng TMP gan vao nh trai
Lam sang
(Noi lien bat thng TMP toan
phan)
Bieu hien lam sang thay oi theo:
- Lo trnh phai trai qua cua mau TMP
e ti nh phai
- Co hay khong co tac nghen tren
lo trnh o
- Mc o thong lien nh
Benh thng nang, 75 90% khong
song en 1 tuoi
14
ECG
ECG
ECG em gai 13
tuoi co NLBTHT/
TMP the tren
tim. AL MP gan
bang ap lc
ong mach he
thong. Song P
nhon D2, aVF.
Truc QRS lech
phai. Day that
phai bieu hien
bang R n pha
V1, song T
ao V1-4 va 18
song S sau
ECG
ECG
ECG be trai 9
thang tuoi co
NLBTHT/ TMP
vao nh phai.
Truc QRS +
900. Day that
phai bieu
hien bang R
cao, n pha
V1 va S sau
V6
20
Xquang
Noi lien TMP toan phan vao xoang vanh, co
hnh anh Xquang giong thong lien nh lo th
2
Noi lien bat thng TMP toan phan vao
TMC tren phai: bong tim co dang so 8
hoacngi tuyet
Khi noi lien bat thng TMP toan phan co
kem tac nghen TMP se co thay oi ro
Xquang hai phoi: dan n TMP va mach bach
huyet, phu phoi mo ke va phe nang, oi
khi thay Kerley B. Hnh anh nay tng phan
vi bong tim khong ln
21
Sieu am tim
1.
Sieu am tim
2. Cac mat cat hu ch
TMP v tr bnh thng: co the thay c
bang cac mat cat:
- 4 buong t mom
- 4 buong di sn
- Vong quanh tren hom c (suprasternal
coronal plane)
- Canh c truc ngang cao
TMC tren trai (hay TM thang ng veine
verticale)
23
Sieu am tim
Mat cat tren hom c: Hnh anh Doppler mau cua noi lien
hoan toan TMP the tren tim vi hnh anh ong thu thap dan
mau t cac TMP ve TM len ben trai (A).Hnh anh noi lien
hoan toan TMP the tren tim vi hnh anh ong thu thap dan
mau t cac TMP ve TM len ben trai, sau o o vao TMC
24
tren phai vave nh phai (B)
Sieu am tim
Sieu am tim
Mat cat di
sn cho thay hnh
anh noi lien bat
thng TMP the
tren tim vi cac
TMP o vao ong
thu thap, ong nay
o vao TMC tren
(C D E). Doppler
ghi nhan pho lien
tuc cua dong 26
mau t ong thu
27
28
29
E. Neu hep xay ra, mau TMP vao nh trai qua cho hep
30