{"id":29968,"date":"2023-05-01T22:55:42","date_gmt":"2023-05-01T15:55:42","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29968"},"modified":"2023-05-01T22:55:42","modified_gmt":"2023-05-01T15:55:42","slug":"hep-van-dong-mach-chu-va-dieu-tri-noi-ngoai-khoa","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/hep-van-dong-mach-chu-va-dieu-tri-noi-ngoai-khoa\/","title":{"rendered":"H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i, ngo\u1ea1i khoa"},"content":{"rendered":"

Van\u00a0\u0111\u1ed9ng m\u1ea1ch\u00a0ch\u1ee7\u00a0c\u00f3 v\u1ecb tr\u00ed \u1edf gi\u1eefa th\u1ea5t tr\u00e1i v\u00e0\u00a0\u0111\u1ed9ng m\u1ea1ch\u00a0ch\u1ee7\u00a0kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng. Bao g\u1ed3m: h\u1eb9p\u00a0van\u00a0\u0111\u1ed9ng m\u1ea1ch\u00a0ch\u1ee7\u00a0v\u00e0 h\u1edf\u00a0van\u00a0\u0111\u1ed9ng m\u1ea1ch\u00a0ch\u1ee7.H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/a> l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd van tim ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n, nam g\u1eb7p nhi\u1ec1u h\u01a1n n\u1eef, gia t\u0103ng theo tu\u1ed5i, t\u1ef7 l\u1ec7 m\u1eafc t\u1edbi 2% \u1edf ng\u01b0\u1eddi tr\u00ean 65 tu\u1ed5i. B\u1ec7nh ng\u00e0y c\u00e0ng tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn do m\u00f4 h\u00ecnh d\u00e2n s\u1ed1 gi\u00e0 ho\u00e1 v\u00e0 c\u00e1c ti\u1ebfn b\u1ed9 trong ch\u1ea9n \u0111o\u00e1n.<\/strong><\/p>\n

1. Nguy\u00ean nh\u00e2n<\/h2>\n
    \n
  • M\u1eafc ph\u1ea3i : H\u1eb9p van \u0110M ch\u1ee7 do v\u00f4i h\u00f3a v\u00e0 tho\u00e1i ho\u00e1 van (th \u01b0\u1eddng g\u1eb7p nh\u1ea5t), b\u1ec7nh th\u1ea5p tim, b\u1ec7nh Paget, suy th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i.<\/li>\n
  • B\u1ea9m sinh: B\u1ec7nh l \u00fd van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 hai l\u00e1 van g\u1eb7p v\u1edbi t\u1ea7n su\u1ea5t 1 – 2% tr\u1ebb s\u01a1 sinh s\u1ed1ng. Van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ch\u1ec9 c\u00f3 hai l\u00e1 van s\u1ebd d\u0201n \u0111\u1ebfn b\u1ea5t th\u01b0\u1eddng d\u00f2ng ch\u1ea3y qua van \u0110M ch\u1ee7 , l\u00e2u d\u00e0i s\u1ebd l\u00e0m c\u00e1c l\u00e1 van x\u01a1 v\u00e0 v\u00f4i h\u00f3a, cu\u1ed1i c\u00f9ng l\u00e0 gi\u1ea3m di\u1ec7n t\u00edch l\u1ed7 van.<\/li>\n<\/ul>\n

    2. B\u1ec7nh sinh<\/h2>\n

    H\u1eb9p van \u0110M ch\u1ee7 d\u0201n \u0111\u1ebfn t\u0103ng tr\u1edf kh\u00e1ng t\u1ed1ng m\u00e1u c\u1ee7a th\u1ea5t tr\u00e1i. H\u1eb9p van ng\u00e0y c\u00e0ng ti\u1ebfn tri\u1ec3n theo th\u1eddi gian d\u0201n t\u1edbi nh\u1eefng bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac th\u1ea5t tr\u00e1i \u0111\u1ec3 th\u00edch nghi. C\u01a1 t\u00e2m th\u1ea5t tr\u00e1i ng\u00e0y c\u00e0ng d\u00e0y l\u00ean \u0111\u1ec3 duy tr\u00ec th\u1ec3 t\u00edch nh\u00e1t b\u00f3p, ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u v\u00e0 th\u1ec3 t\u00edch cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng, m\u1eb7c d\u00f9 ch\u00eanh \u00e1p th\u00ec t\u00e2m thu gi\u1eefa t\u00e2m th\u1ea5t tr\u00e1i v\u00e0 \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean ng\u00e0y c\u00e0ng gia t\u0103ng.<\/p>\n

    Khi t\u00ecnh tr\u1ea1ng h\u1eb9p van ti\u1ebfp t\u1ee5c ti\u1ebfn tri\u1ec3n ho\u1eb7c kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, qu\u00e1 tr\u00ecnh ph\u00ec \u0111\u1ea1i c\u01a1 tim ti\u1ebfp t\u1ee5c ti\u1ebfn tri\u1ec3n, c\u01a1 tim dung n\u1ea1p ng\u00e0y c\u00e0ng k\u00e9m, th\u1ec3 t\u00edch cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng t\u0103ng l\u00ean m\u1eb7c d\u00f9 k\u00edch th\u01b0\u1edbc bu\u1ed3ng tim ch\u01b0a thay \u0111\u1ed5i. R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng th\u1ea5t tr\u00e1i g\u00f3p ph\u1ea7n d\u0201n \u0111\u1ebfn bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng \u0111\u1ea7u ti\u00ean. B\u00ean c\u1ea1nh \u0111\u00f3 qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac, x\u01a1 h\u00f3a, thi\u1ebfu m\u00e1u c\u01a1 tim khi\u1ebfn cho co b\u00f3p kh\u00f4ng c\u00f2n hi\u1ec7u qu\u1ea3.<\/p>\n

    3. \u0110i\u1ec1u tr\u1ecb<\/h2>\n

    3.1 \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/strong><\/h3>\n

    Ch\u01b0a c\u00f3 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa n\u00e0o \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 th\u1ec3 ng\u0103n ng\u1eeba qu\u00e1 tr\u00ecnh ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh hay c\u1ea3i thi\u1ec7n ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh.<\/p>\n

    Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0m gi\u1ea3m nhu c\u1ea7u oxy c\u01a1 tim v\u00e0 c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n l\u01b0u l\u01b0\u1ee3ng t\u01b0\u1edbi m\u00e1u v\u00e0nh.<\/p>\n

    S\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u quai v\u1edbi li\u1ec1u nh\u1ecf v\u00e0 theo d\u00f5i s\u00e1t b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m ti\u1ec1n g\u00e1nh v\u00e0 gi\u00fap gi\u1ea3m tri\u1ec7u ch\u1ee9ng kh\u00f3 th\u1edf (tr\u00e1nh gi\u1ea3m th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n).<\/p>\n

    V\u1edbi b\u1ec7nh nh\u00e2n suy tim sung huy\u1ebft ho\u1eb7c th\u1ea5t tr\u00e1i gi\u00e3n, digoxin c\u00f3 th\u1ec3 gi\u00fap \u0111i\u1ec1u tr\u1ecb kh\u00f3 th\u1edf (\u0111\u1eb7c bi\u1ec7t l\u00e0 n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 rung nh\u0129 ho\u1eb7c cu\u1ed3ng nh\u0129).<\/p>\n

    \u1ede b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 n\u1eb7ng: Tr\u00e1nh d\u00f9ng thu\u1ed1c gi\u1ea3m co b\u00f3p v\u00e0 thu\u1ed1c l\u00e0m gi\u1ea3m ti\u1ec1n g\u00e1nh (v\u00ed d\u1ee5: Glyceryl trinitrate, thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n) v\u00ec nh\u1eefng thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m cung l\u01b0\u1ee3ng tim v\u00e0 g\u00e2y tri\u1ec7u ch\u1ee9ng ng\u1ea5t.<\/p>\n

    3.2 Ch\u1ec9 \u0111\u1ecbnh thay van<\/h3>\n

    \"H\u1eb9p<\/p>\n

    Ch\u1ec9 \u0111\u1ecbnh thay van tim \u1edf b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 (AHA\/ACC 2014)<\/strong><\/p>\n

    *Thay van \u0110M ch\u1ee7 n\u00ean c\u00e2n nh\u1eafc \u1edf h\u1eb9p van \u0110M ch\u1ee7 giai \u0111o\u1ea1n D3 n\u1ebfu t\u1eafc ngh\u1ebdn t\u1ea1i van g\u1ea7n nh\u01b0 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng, ch\u1ec9 s\u1ed1 th\u1ec3 t\u00edch nh\u00e1t b\u00f3p (stroke volume index) <35 mL\/m2, ch\u1ec9 s\u1ed1 di\u1ec7n t\u00edch l\u1ed7 van \u0110M ch\u1ee7 \u22640,6 cm2\/m2 v\u00e0 d\u1eef li\u1ec7u \u0111\u01b0\u1ee3c ghi nh\u1eadn khi b\u1ec7nh nh\u00e2n c\u00f3 huy\u1ebft \u00e1p b\u00ecnh th\u01b0\u1eddng (HATT <140 mmHg).<\/em><\/p>\n

    4.\u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt<\/h2>\n

    Ph\u0201u thu\u1eadt l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 v\u1edbi b\u1ec7nh nh\u00e2n h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/p>\n

    B\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 kh\u00edt c\u00f3 tri\u1ec7u ch\u1ee9ng m\u1ea5t b\u00f9 c\u1ea5p c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb nh\u01b0 m\u1ed9t c\u1ea5p c\u1ee9u.<\/p>\n

    N\u00ean thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 cho nh\u1eefng b\u1ec7nh nh\u00e2n h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 t\u1eeb m\u1ee9c \u0111\u1ed9 v\u1eeba tr \u1edf l\u00ean ch\u01b0a c\u00f3 tri\u1ec7u ch\u1ee9ng nh\u01b0ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh ph\u0201u thu\u1eadt kh\u00e1c tr\u00ean tim nh\u01b0 ph\u0201u thu\u1eadt b\u1eafc c\u1ea7u n\u1ed1i ch\u1ee7 v\u00e0nh, ph\u0201u thu\u1eadt van tim kh\u00e1c.<\/p>\n

    Thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 (t\u1ef7 l\u1ec7 t\u1eed vong quanh ph\u0201u thu\u1eadt l\u00e0 1%, bi\u1ebfn ch\u1ee9ng sau ph\u0201u thu\u1eadt l\u00e0 1%\/n\u0103m t\u1ea1i c\u00e1c trung t\u00e2m c\u00f3 nhi\u1ec1u kinh nghi\u1ec7m, tuy nhi\u00ean s\u1ed1 li\u1ec7u t\u1eeb nh\u1eefng nghi\u00ean c\u1ee9u s\u1ed5 b\u1ed9 qu\u1ed1c gia cho th\u1ea5y t\u1ef7 l\u1ec7 t\u1eed vong quanh ph\u0201u thu\u1eadt kho\u1ea3ng 3%).<\/p>\n

    Van sinh h\u1ecdc n\u00ean \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn cho nh\u1eefng b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, v\u00e0 c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i n\u1ebfu mu\u1ed1n tr\u00e1nh nguy c\u01a1 huy\u1ebft kh\u1ed1i ho\u1eb7c xu\u1ea5t huy\u1ebft (\u01af\u1edbc t\u00ednh kho\u1ea3ng 2 – 4 %\/ n\u0103m).<\/p>\n

    5.Nong van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1eb1ng b\u00f3ng qua da<\/h2>\n

    L\u00e0 \u0111i\u1ec1u tr\u1ecb thay th\u1ebf t \u1ea1m th\u1eddi cho ph\u0201u thu\u1eadt ho \u1eb7c TAVI \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 n\u1eb7ng.<\/p>\n

    Ti\u00ean l \u01b0\u1ee3ng gi\u1ed1ng nh\u01b0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa v\u00ec bi\u1ebfn ch\u1ee9ng xung quanh th\u1ee7 thu\u1eadt (kho\u1ea3ng 3% t\u1eed vong v\u00e0 6% nh\u1ed3i m\u00e1u c\u01a1 tim, h\u1edf van \u0110M ch\u1ee7 n\u1eb7ng , v\u1ee1 th\u1ee7ng tim) v\u00e0 t\u1ef7 l\u1ec7 t\u00e1i h\u1eb9p cao (50% trong v\u00f2ng 3 – 6 th\u00e1ng).<\/p>\n

    5.1 Ch\u1ec9 \u0111\u1ecbnh:<\/h3>\n

    Tr\u1ebb em, thanh thi\u1ebfu ni\u00ean h\u1eb9p van \u0110M ch\u1ee7 van kh\u00f4ng b\u1ecb v\u00f4i ho\u00e1. B\u1ec7nh n h\u00e2n kh\u00f4ng ph\u00f9 h\u1ee3p v\u1edbi ph\u0201u thu\u1eadt ho\u1eb7c t\u1eeb ch\u1ed1i ph\u0201u thu\u1eadt.<\/p>\n

    Gi\u1ea3i ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ea1m th\u1eddi cho b\u1ec7nh nh\u00e2n trong l\u00fac ch\u1edd thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 qua da (T AVI) ho\u1eb7c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u1ea5p c\u1ee9u cho nh\u1eefng b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 c\u00f3 tri\u1ec7u ch\u1ee9ng m\u1ea5t b\u00f9 c\u1ea5p tr\u01b0\u1edbc khi ti\u1ebfn h\u00e0nh ph\u0201u thu\u1eadt.<\/p>\n

    6.Thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 qua \u0111\u01b0\u1eddng \u1ed1ng th\u00f4ng (TAVI)<\/h2>\n

    Thay van \u0110M ch\u1ee7 qua \u0111\u01b0\u1eddng \u1ed1ng th\u00f4ng l\u00e0 th\u1ee7 thu\u1eadt x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u nh\u01b0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p thay th\u1ebf cho ph\u0201u thu\u1eadt thay van nh\u00e2n t\u1ea1o \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 n\u1eb7ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh thay van.<\/p>\n

    Th\u1ee7 thu\u1eadt th\u01b0\u1eddng \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh qua \u0111\u01b0\u1eddng \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i, trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 ti\u1ebfp c\u1eadn qua \u0111\u01b0\u1eddng \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n, ho\u1eb7c \u0111\u01b0a tr\u1ef1c ti\u1ebfp qua \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 th\u00f4ng qua m\u1ed9t \u0111\u01b0\u1eddng v\u00e0o t\u1ed1i thi\u1ec3u qua th\u00e0nh ng\u1ef1c. Van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 nh\u00e2n t\u1ea1o s\u1ebd \u0111\u01b0\u1ee3c \u0111\u1eb7t trong l\u00f2ng van t\u1ef1 nhi\u00ean c\u1ee7a b\u1ec7nh nh\u00e2n sau khi \u0111\u01b0\u1ee3c nong b\u1eb1ng b\u00f3ng. T\u1eeb n\u0103m 2019, thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 qua da \u0111\u00e3 \u0111\u01b0\u1ee3c m\u1edf r\u1ed9ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1ebfn c\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ph\u0201u thu\u1eadt th\u1ea5p \u0111\u1ebfn v\u1eeba.<\/p>\n

    6.1 Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h3>\n

    Tuy\u1ec7t \u0111\u1ed1i<\/strong><\/p>\n

      \n
    • L\u00e2m s\u00e0ng: Ti\u00ean l\u01b0\u1ee3ng s\u1ed1ng < 1 n\u0103m. S\u1ef1 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng kh\u00f4ng \u0111\u1ea3m b\u1ea3o do c\u00e1c t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd kh\u00e1c. T\u1ed5n th\u01b0\u01a1ng n\u1eb7ng c\u00e1c van tim kh\u00e1c khi tri\u1ec7u ch\u1ee9ng ch\u1ec9 c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u01b0\u1ee3c b\u1eb1ng ph\u0201u thu\u1eadt.<\/li>\n
    • Gi\u1ea3i ph\u0201u kh\u00f4ng ph\u00f9 h\u1ee3p cho k\u1ef9 thu\u1eadt: \u0110\u01b0\u1eddng k\u00ednh v\u00f2ng van kh\u00f4ng t\u01b0\u01a1ng x\u1ee9ng (< 18 mm ho\u1eb7c > 29 mm), huy\u1ebft kh\u1ed1i th\u1ea5t tr\u00e1i, vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng, kho\u1ea3ng c\u00e1ch l\u1ed7 van \u0110M ch\u1ee7 v\u00e0 l\u1ed7 \u0110MV qu\u00e1 ng\u1eafn, c\u00f3 m\u1ea3ng di \u0111\u1ed9ng trong \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean ho\u1eb7c quai \u0110M ch\u1ee7, v\u1ecb tr\u00ed ti\u1ebfp c\u1eadn (\u0111\u00f9i, d\u01b0\u1edbi \u0111\u00f2n) kh\u00f4ng ph\u00f9 h\u1ee3p: \u0110\u01b0\u1eddng v\u00e0o, k\u00edch th\u01b0\u1edbc m\u1ea1ch g\u1ea5p kh\u00fac, v\u00f4i h\u00f3a…<\/li>\n
    • Van \u0110M ch\u1ee7 2 l\u00e1 van, 1 l\u00e1 van, t\u1ed5n th\u01b0\u01a1ng van \u0110M ch\u1ee7 do th\u1ea5p.<\/li>\n
    • H\u1edf van \u0110M ch\u1ee7 n\u1eb7ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb trong l\u1ef1a ch\u1ecdn b\u1ec7nh nh\u00e2n l\u00e0m TAVI, tuy nhi\u00ean JenaValve \u0111ang \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m \u0111i\u1ec1u tr\u1ecb nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u00f3 h\u1edf van \u0110M ch\u1ee7 n\u1eb7ng.<\/li>\n
    • B\u1ec7nh l\u00fd \u0110MV kh\u00f4ng can thi\u1ec7p b\u1eb1ng t\u00e1i th\u00f4ng \u0111\u01b0\u1ee3c, huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh, EF < 20%, b\u1ec7nh ph\u1ed5i n\u1eb7ng.<\/li>\n<\/ul>\n

      T\u01b0\u01a1ng \u0111\u1ed1i:<\/strong><\/p>\n

        \n
      • Van \u0110M ch\u1ee7 2 l\u00e1 van, 1 l\u00e1 van, t\u1ed5n th\u01b0\u01a1ng van \u0110M ch\u1ee7 do th\u1ea5p.<\/li>\n
      • H\u1edf van \u0110M ch\u1ee7 n\u1eb7ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb trong l\u1ef1a ch\u1ecdn b\u1ec7nh nh\u00e2n l\u00e0m TAVI, tuy nhi\u00ean JenaValve \u0111ang \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m \u0111i\u1ec1u tr\u1ecb nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u00f3 h\u1edf van \u0110M ch\u1ee7 n\u1eb7ng.<\/li>\n
      • B\u1ec7nh l\u00fd \u0110MV kh\u00f4ng can thi\u1ec7p b\u1eb1ng t\u00e1i th\u00f4ng \u0111\u01b0\u1ee3c, huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh, EF < 20%, b\u1ec7nh ph\u1ed5i n\u1eb7ng.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

        Van\u00a0\u0111\u1ed9ng m\u1ea1ch\u00a0ch\u1ee7\u00a0c\u00f3 v\u1ecb tr\u00ed \u1edf gi\u1eefa th\u1ea5t tr\u00e1i v\u00e0\u00a0\u0111\u1ed9ng m\u1ea1ch\u00a0ch\u1ee7\u00a0kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng. Bao g\u1ed3m: h\u1eb9p\u00a0van\u00a0\u0111\u1ed9ng m\u1ea1ch\u00a0ch\u1ee7\u00a0v\u00e0 h\u1edf\u00a0van\u00a0\u0111\u1ed9ng m\u1ea1ch\u00a0ch\u1ee7.H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd van tim ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n, nam g\u1eb7p nhi\u1ec1u h\u01a1n n\u1eef, gia t\u0103ng theo tu\u1ed5i, t\u1ef7 l\u1ec7 m\u1eafc t\u1edbi 2% \u1edf […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nH\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i, ngo\u1ea1i khoa - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd van tim ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n, nam g\u1eb7p nhi\u1ec1u h\u01a1n n\u1eef, gia t\u0103ng theo tu\u1ed5i.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i, ngo\u1ea1i khoa - 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