“解构操作”超声·CT·透视多模态影像拆解手术操作； Anatomy in Action: Decoding Structural Procedures via Triple Imaging——session 3 - 房间隔穿刺教学
07/10 15:00-16:30
分会场5-悦府11
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15:00-16:30Course Director：陈样新、庄晓东、姚晶、丁风华、钟禹成、叶志东、段福建、陈涛
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15:00-16:30主席
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15:00-16:30协调人
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15:00-16:30讲师团
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15:00-15:10Mini Lecture: 声“形”兼备，洞若观火：超声影像解构房间隔穿刺的立体空间；Sensing the Septum: Echocardiographic Anatomy for Flawless Transseptal Puncture
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15:10-15:20Mini Lecture: 双“影”齐飞：CT三维重建与X线透视在房间隔穿刺中的跨界融合；Fusion and Alignment: The Synergy of CT Planning and Fluoroscopy in Transseptal Puncture
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15:20-15:30Mini Lecture: 行云流水，一针见血：高成功率房间隔穿刺的实战复盘与习惯分享；Precision in Motion: Practical Habits and Insights for Efficient Transseptal Access
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15:30-15:47实战模拟；Dry Lab Simulator: Step-by-Step Transseptal Puncture
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15:47-16:30Trouble shooting；不同的手术房间隔穿刺要点？外科术后房间隔穿刺要点？巨大左房如果寻找合适的房穿点？巨大右房如何寻找合适的房穿点？TMVR如何平衡通过性与同轴性？哪些操作容易产生并发症？如何标准化操作最大程度避免并发症？常规食道引导下还有没有必要穿刺后给肝素？遇到多次射频消融术后、严重纤维化或有外科房间隔修补补片（如Dacron/心包补片）的“极硬房间隔”，常规穿刺针反复滑脱、无法通过时，应该如何安全地运用电外科或经中空针送入小球囊扩张进行强行通关？如何避免穿刺针意外弹跃导致心壁穿孔？在面对巨大膨出、甚至呈多孔筛状的房间隔瘤（ASA）患者时，穿刺针极易带陷房间隔而无法突破，或者由于多孔反流导致超声定位模糊，如何确保穿刺点精确且不发生针尖滑脱错位？Tailoring the puncture: What are the distinct transseptal requirements for different structural procedures (e.g., MitraClip vs. LAAC)? Navigating the altered anatomy: Key considerations for transseptal puncture after cardiac surgery. Anatomical distortion: Finding the sweet spot in massive left atrium or massive right atrium dilation. The TMVR dilemma: Balancing sheath deliverability with device coaxiality during septal puncture. Which maneuvers provoke complications, and how do we standardize the procedure to prevent them? Anticoagulation timing: Is post-puncture heparinization still mandatory under routine TEE guidance? The floppy atrial septal aneurysm (ASA): Preventing needle slippage and ensuring precise height in a mobile septum.