New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you?
3:56-7:06
This is the front page of the document that Maya and Abe and I are going to review. Some of the information on updates in genetic aortic disease, its evaluation management, medical therapy, surgical guidelines, pregnancy management, shared decision making and really it's, it's a whole new document, totally rewritten from 2010.
こちらがこのウェビナーで解説するガイドラインの最初のページです。遺伝性大動脈疾患、評価管理、治療法、手術ガイドライン、妊娠管理、共同での意思決定に関する最新情報が掲載されています。2010年版から一新され、全く別の文書になっています。
And I just want to highlight in, in the red and blue arrows on the writing committee members the, the leads on this were Eric Isselbacher from Mass General, Ourania Preventza from Houston and Jim Black from Johns Hopkins and the, the worker bees where all the rest of us who did the writing and communicating back and forth and I highlight how many people that were on the writing committee are intimately involved and have dedicated their really, their volunteering and their time to The Marfan Foundation and other foundations that serve our communities, so that was made us very proud to have so many people involved and, and many of the members are listed here. Some on the boards, some like Abe and others, Jim Black are advisors and just vital members of our professional community, next slide.
ガイドライン執筆委員会では、Eric Isselbacher氏（Massachusetts General Hospital）が委員長、Ourania Preventza氏（Baylor College of Medicine）とJames Hamilton Black III氏（Johns Hopkins Hospital）が副委員長を務めました。多くのメンバーが緊密に連携しながら、The Marfan Foundationを始めとする団体のために、篤志で執筆に携わりました。水色の矢印で示されているのは、The Marfan Foundationの専門家委員会のメンバーで、Abe氏やBlack氏にはアドバイザーを務めていただいています。
We're going to talk tonight about the aorta and its branches and the management, so I thought we'd just start with a, with just an anatomy lesson so everybody's together on this.
では今回のテーマである、大動脈や分岐動脈、その管理についてお話したいと思いますので、大動脈の構造から説明します。
So you can see the body over there in the top left of your screen and then, the red tube shaped like a cane, of course, everybody in this audience knows, knows the aorta and the anatomy probably better than most and, and so we're going to talk about different anatomical parts of the aorta so as a refresher.
スライドの左上に全身の画像があります。杖のような形をした赤い管が皆さんご存知の大動脈で、構造についても十分に理解されていると思いますので、大動脈の各部位について再確認の意味も込めて説明します。
The heart is, is kind of shaded away but the aorta arises from the heart. It's the largest blood vessel of the body. It's about the size of a garden hose in a young adult and a little bit larger in older adults and the root is the beginning part of the aorta encompassing the valve and the coronary arteries and then the ascends up to the level of the vessels that supply the arteries to the head and the neck and that's the ascending aorta and then the arch or where those hatched lines are that defined by the ascending aorta and the descending aorta in between is the arch where the head vessels come off and then the descending aorta where the aorta descends in front of the spine all the way down the back to the level of the diaphragm to enter the abdomen that's the descending aorta. We're not going to spend much time on the abdominal aorta but, but it's a vital part of the anatomy, especially in aortic dissection because all those tubes can have lack of blood flow or malperfusion meaning not enough blood flow to vital organs which can be very serious that Dr. DeAnda is going to talk about in some of the strategies now employed for managing acute aortic dissection, so this is aorta. We call it the tube of life and it's a very, very vital structure for all of us.
薄く見えているのが心臓で、大動脈はこの部分から始まります。大動脈は体の中で最も太い血管です。大動脈の太さは、お子さんですと庭に水をまくホースくらいで、大人になるともう少し太くなります。大動脈の基部が大動脈の始まりで、基部内には大動脈弁があり、基部から冠動脈が出ています。基部から伸びた大動脈は、頭や首へと分岐する動脈の高さまで上昇します。ここまでの部分を上行大動脈と呼びます。斜めの点線で区切られた部分が大動脈弓です。大動脈弓からは頭に向かう動脈が出ています。その後、大動脈は背骨の前で下行し、横隔膜に向かって下り腹部に入ります。この部分が下行大動脈です。このウェビナーでは腹部大動脈については深入りしませんが、特に大動脈解離では重要になります。大動脈解離が起きると、大動脈の血流がなくなる灌流障害が生じ、重要な臓器への血流が不足することになるからです。DeAnda先生からは、後ほど急性大動脈解離の現在の管理方法についてお話いただきます。以上が、命の管とも呼ばれ、極めて重要な構造である大動脈の説明です。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
