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Diastole Systole
Cardiac Disease ,[object Object],[object Object],[object Object],[object Object],[object Object]
The Coronary Circulation
Coronary Origin (LM) (LM) (LAD) (RCA) (Circ)
Atherogenesis
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Balloon Angioplasty
Stent   NIRยฎ stent   Medinol Ltd.
Balloon Expended Stent
Self Expanded Stent
Main Problem with Angioplasty: =>In Stent Restenosis
Restenosis
Drug Eluting Stents (DES) ,[object Object],BMS DES DES: cons and pros: http://www.clalit.org.il/HE-IL/General/heart/prevent/articles/stent.htm
Another Problem : =>Vulnerable Plaque
THE PATHOGENESIS OF ATHEROSCLEROSIS Schematic longitudinal section of an artery showing different stages of atherosclerotic plaque vulnerability:  A, Normal;  B, Rupture-prone plaque;  C, Plaque rupture with fissure;  D, Critical stenosis;  E, Erosion-prone plaque;  F, Intra-plaque hemorrhage.
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=>Total Occlusion
Total Occlusion
Anatomy of the Heart ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Heart Valves Left ventricle Right ventricle
Valvular stenosis a narrowing, stiffening, thickening, fusion or blockage of one or more valves Valvular regurgitation blood leakage back in the wrong direction because improperly valveโ€™s closure Valve prolapsed Valvular Heart Cardiac Disease http://www.heartlibrary.com/heart-library-heart-valve-repair-replacement.aspx
Aortic Valve Stenosis
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Aortic valve - 63%  Mitral valve โ€“ 14%
Heart Valve Repair
ื˜ื›ื ื•ืœื•ื’ื™ื•ืช ืจืคื•ืื™ื•ืช :   ื›ื™ืจื•ืจื’ื™ืช ืœื‘  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Heart-Lung Machine Cardiopulmonary bypass (CPB) Schematic Explanation:  http://www.youtube.com/watch?v=RlRi3R9LXng In vivo use:  http://www.youtube.com/watch?v=tGgs2zm6HFU&NR=1 CPB (the machine) :  http:// www.youtube.com/watch?v = dNHcJQFPrDk
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Oxygenator (Heart-Lung machine)
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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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Aortic Perfusion Cannula
http://www.terumo-cvsmedia.com/flash.php?nm=sarns_soft_flow
Venous Return Single stage Dual stage
Retrograde Catheters
Femoral Cannulae
ืชืกื—ื™ืคื™ื ื•ื‘ื•ืขื™ื•ืช ื‘ื“ื ,[object Object]
Coronary Artery Bypass Graft (CABG) ,[object Object],http://www.youtube.com/watch?v=RZhPZc1Uhws
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Prosthetic Heart Valves
Heart Valve Replacement http://www.fda.gov/hearthealth/flash/fda_26.html
Prosthetic Heart Valves (PHV) ,[object Object],[object Object]
Heart Valve Replacement
Heart Valve Replacement http://www.youtube.com/watch?v=o6xS3sYSAl8 http://il.youtube.com/watch?v=G95lk41TmsU   Bioprosthetic (solo)   http://www.e-med.co.il/emed/new/usersite/presentations/bepex/bepex_solo.html
Actual Geometry  after valve implantation
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Tilting Disk MHV  (Bjork-Shiley) Bileaflet MHV (St.Jude) Caged Ball MHV
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Flexible Valves Tri-leaflet silastic reinforced leaflets Bioprosthetic (tissue) Valve
Minimally invasive valve treatment  ,[object Object],[object Object],[object Object],Mitral Valve Repare: http://www.e-med.co.il/emed/new/Usersite/Presentations/Cardio1109b/Raanani_P_files/Default.htm#nopreload=1  slide 12
Additional Movies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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overview on cardioplegia by Dr. Idit Avrahami

Editor's Notes

  1. When the atrtiums are compressed and the ventricles are filled with blood it is called diastoly and when the ventricles are compressed and flow is pushe away, it is called systole.
  2. After the operation, the patient will spend 7 to 10 days in the hospital, the first 1 to 3 days in an intensive-care unit (ICU). Chest tubes will be in place for the first 2 to 3 days to drain any residual blood and fluid from around the heart. Heart functions will be monitored. The full benefits from the operation may not be ascertained until 3 to 6 months after surgery. Sexual activity may be resumed 3 to 4 weeks after surgery. All activities that do not cause fatigue are permitted, but the patient must not strain the healing chest bone (sternum).