超声心动图在双主动脉弓诊断及术后评价中的应用

目的 探讨超声心动图在双主动脉弓患儿术前诊断及术后评价中的作用.方法 回顾分析住院治疗的6例双主动脉弓患儿的临床及超声影像资料.结果 6例息儿中超声心动图诊断双主动脉弓4例,其中右弓占优势型3例,左右弓平衡型1例.平衡型双主动脉弓左侧主动脉弓和右侧主动脉弓内径基本相同,右弓占优势型的右侧主动脉弓内径明显大于左侧主动脉弓内径,左右侧主动脉弓上分别发出二支头臂动脉;超声心动图检查漏诊2例,均为左右弓平衡型.3例同时合并其他心内畸形.5例息儿手术治疗,术后最长随访时间为2年半.结论 超声心动图胸骨上窝切面显示无论是右位主动脉弓还是左位主动脉弓,当仅见二支头臂动脉发出时应高度警惕双主动脉弓的可能;超声心动图是双主动脉弓手术前后有效的无创检查方法.

The role of echocardiography in diagnosis and management of double aortic arch

Objective To evaluate the role of echocardiography in diagnosis and post-operative evaluation of infants and children with double aortic arch. Methods Echocardiography was performed in 6 patients with double aortic arch from January 2006 to June 2008. The outcome of postoperative follow-up was also evaluated. Results Six patients ranged in age from 3 months to 4 years and averaged 18 months. There were 2 boys and 4 girls. Echocardiography diagnosed double aortic arch in 4 patients, one balanced arch and 3 right arch dominant, and was confirmed by surgical observation in each patient. The size of the two arches were almost same in balanced arch,and the diameter of right arch was bigger than that of left arch in right arch dominant. Echocardiography failed to diagnose in 2 patients with balanced arch. Three patients had associated heart defect, such as patent ductus arteriosus and ventricular septal defect. Five of the 6 patients underwent surgical division of the left arch in order to relieve esophageal and tracheal compression. At about 2 years postoperative follow-up,echocardiography can clearly show the flow of aortic arch and it's branches. Conclusions It is an important clue to double aortic arch if only two branches of aortic arch was shown on supersternal view by echocardiography. As a non-invasive techniqe, echocardiography is useful for diagnosing and post-operative evaluating of patients with double aortic arch.