房间隔完整的三房心一例

患者女性,4岁,生后2岁患“急性肺炎”在当地医院查体时发现心脏杂音。1岁会行走,运动后心悸气喘。查体:无紫绀及杵状指(趾)。肝脾未触及,心界稍向左扩大。胸骨左缘3～4肋间可闻及Ⅱ～Ⅲ级喷射性收缩期杂音,肺动脉第二音偏强,心尖区未闻及流     

成人法乐四联症手术前后左室容积和收缩功能的比较

目的 :对比成人法乐四联症 （TOF）手术前后左室容积和收缩功能变化。方法 :TOF 3 2例在手术前后分别用超声心动图测量左室舒张末期和收缩末期内径 ,计算出左室舒张末期容积、收缩末期容积、每搏搏出量、射血分数和短轴缩短率。结果 :手术后左室容积比手术前明显增大 （P<0 .0 1） ;左室收缩功能手术前后无明显改变 （P>0 .0 5 ）。结论 :成人 TOF手术前后只是左室容积变化 ,而左室收缩功能不受影响     

实时三维超声心动图在室间隔缺损介入治疗中的应用进展

研究了实时三维超声在室间隔缺损介入治疗的应用进展情况,综述了实时三维超声心动图在经导管室间隔缺损封堵术治疗之前的诊断,介入治疗中的监测及术后疗效评价的优势,最后指出了实时三维超声心动图在室间隔缺损的诊断和治疗等方面具有重要的临床价值。     

动脉导管未闭结扎术后发现漏诊主肺动脉间隔缺损1例

病例报告：患者，女，9岁。运动后心慌气短4年于1996-09-19入院．查体：体温36．0℃，血压12／8 kPa，神志清楚，无紫绀及杵状指(趾)，无颈静脉怒张。双肺呼吸音清。心界向左下扩大。心率100／min，律齐。胸骨左肋3肋间闻及连续性杂音，心尖部可闻及舒张期流量杂音。肝脾不大．双下肢无浮肿。     

房间隔缺损介入治疗后随诊观察

目的评价房间隔缺损(ASD)介入治疗的近期及远期疗效。方法继发孔型ASD 428例,单一ASD 416例,多发ASD 12例,合并畸形70例。使用美国AGA-Amplatzer ASD闭合器及国产闭合器闭合ASD。结果428例ASD患者成功介入425例,介入技术成功率99.3%。介入手术并发症总发生率2.1%。合并畸形介入治疗成功率100%。425例患者介入后第2、3天行ECG、TTE及X线检查,均有不同程度的改善,其中225例患者于术后1个月、3个月、半年、1年以上进行心电图(ECG)、经胸超声心动图(TTE)及X线随诊,最长达6年。远期随诊主要症状为头痛,杂音消失80%。ECG不完全性右束支传导阻滞(IRBBB)在1年内可由72%降至3%,但ECG近期及远期效果心律失常发生率较高。TTE近期改变主要右室流出道(RVOT)及右室(RV)内径明显变小,远期随诊主要为房室瓣返流,均为轻度,残余漏仅1例,X线胸片心胸比值近、远期疗程均明显缩小。结论ASD介入治疗近期、远期疗效十分理想。     

房间隔膨出瘤及合并畸形52例临床报告

目的：探讨房间隔膨出瘤（IASA）合并畸形的诊断特征及治疗适应证。方法：32例IASA合并畸形的住院患者及20例孤立性IASA门诊随诊患者,经心电图（ECG）、胸片、体表超声（TTE）、食道超声（TEE）及心导管检查,选择外科开胸,内科介入及门诊随诊观察的IASA患者。结果：32例IASA合并畸形的住院患者,16例（50%）合并畸形行外科开胸手术治疗,其中7例合并多发性房间隔缺损（ASD）。16例（50%）IASA合并ASD行内科介入治疗,其中6例为多发性ASD。结论：IASA合并畸形最常见的为ASD,而ASD中多发性ASD较为常见,通过TTE及TEE准确诊断,选择内、外治疗适应证。     

彩色多普勒超声心动图诊断冠状动脉瘘

应用彩色多普勒超声心动图(CDE)检查了10例冠状动脉瘘,提出了新的分型法。按此法,本组中右冠状动脉右室瘘5例,右冠状动脉左室瘘、右房瘘和肺动脉瘘各1例,左冠状动脉左室瘘和右室瘘各1例。9例有心血管造影资料,10例均经手术证实。结果表明本病彩色多普勒所示的异常分流束血流信号与哪支冠状动脉发生瘘无关,而与引流开口的心腔有密切关系。     

连续波多普勒超声心动图对室间隔缺损患者肺动脉压力估测

对47例(经心脏手术证实)VSD患者手术前用CWD估测PASP,并与术前RHC的测值进行对比,结果是两者显著相关(r=0.93);但CWD对PASP正常或仅轻度升高者易发生高估,对PASP严重增高者易于低估,并对造成这种估测偏差的原因进行了讨论。     

两腔心及合并畸形的彩色多普勒超声心动图特征研究

Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.