婴幼儿完全性大动脉调转术术前超声心动图诊断分析

目的评价超声心动图诊断婴幼儿完全性大动脉转位的准确性。方法对象为45例超声心动图检查确诊后行大动脉调转术(ASD)患者。术前超声心动图均对左心功能、大动脉及合并畸形进行评估,与手术结果对照分析。结果 45例室间隔完整型大动脉转位29例(合并房间隔缺损、动脉导管未闭13例,单纯合并动脉导管未闭6例,单纯合并房间隔缺损8例,单纯合并卵圆孔未闭2例);大动脉转位伴室间隔缺损16例(单纯伴室间隔缺损5例,单纯合并房间隔缺损3例,单纯合并卵圆孔未闭2例,合并房间隔缺损、动脉导管未闭5例,卵圆孔未闭、动脉导管未闭1例)。与手术结果比较超声心动图诊断大动脉转位准确率为97.8%;合并畸形诊断准确率为91.1%。45例中冠状动脉发育正常41例;冠状动脉畸形4例,其中2支冠状动脉起源右冠状窦2例,1例因声窗差未能显示,左右冠状动脉发育细小走形于主动脉后壁1例,右冠状动脉起源于肺动脉1例,超声诊断准确率为75%。结论超声心动图能比较准确的诊断大动脉转位及心内合并畸形,为临床提供重要诊断信息。

Echocardiography preoperative diagnosis for infants to be received complete arterial switch operation

Objective To evaluate the role of echocardiographic diagnosis for infants to be received complete transposition of great arteries. Method The 45 cases were confirmed by echocardiography to be underwent arterial switch operation (ASD) in this study. Both preoperative echocardiography of left ventricular function, artery and malformation assessment were compared with surgical findings. Results Among the 45 cases transposition of great arteries with intact ventricular septum was in 29 patients (atrial septal defect, patent ductus arteriosus in 13 cases, simple patent ductus arteriosus in 6 cases, a simple atrial septal defect in 8 cases, a simple combined oval hole is not closed 2 cases); transposition of great arteries with ventricular septal defect in 16 patients (ventricular septal defect in 5 cases, simple atrial septal defect in 3 cases, simply merge in 2 cases of patent foramen ovale, atrial septal defect, 5 cases of patent ductus arteriosus, foramen ovale ovale, patent ductus arteriosus, 1 case). Compared with surgical findings accuracy rate of echocardiographic diagnosis of transposition of great arteries was 97.8%, diagnostic accuracy for malformation was 91.1%. Among the 45 cases, there were 41 patients with normal coronary artery development. Coronary artery in 4 cases, two of which coronary artery originating from right coronary sinus in 2 cases, one case failed to show due to poor acoustic windows. Development of small and out of shape about coronary aortic wall in 1 case, the right coronary artery originating from the pulmonary artery in 1 case, ultrasound diagnostic accuracy’s rate was 75%. Conclusion Echocardiography can be a more accurate diagnosis of transposition of great arteries and heart malformation, may provide important clinical diagnostic information.