完全型冠状静脉窦隔缺损的超声心动图诊断

目的探讨多普勒超声心动图对完全型冠状静脉窦隔缺损(coronary sinus septal defect,CSSD)的诊断价值.方法以经右心导管检查及外科手术治疗的10例完全型冠状静脉窦隔缺损患者为研究对象,回顾性分析其二维及多普勒超声表现.结果 10例完全性CSSD患者中,超声诊断3例,诊断正确率30%;漏诊7例,占70%.10例完全型冠状静脉窦隔缺损患者中,10例均合并左侧上腔静脉残存,9例合并房间隔缺损,其中4例为房室间隔缺损,5例为房间隔缺损或大型房间隔缺损(近似功能性单心房).10例均合并于复杂型先天性心脏病中,其中7例合并右室双出口、法乐四联症、单心室等紫绀型先心病,3例为部分型房室间隔缺损和功能性单心房患者.结论在复杂型先心病合并左上腔静脉残存或房间隔缺损时应警惕完全型冠状窦隔缺损的存在,以免漏诊.

Echocardiography in diagnosing complete sinus septal defects

Objective To explore the value of echocardiography in diagnosing complete coronary sinus septal defects (CSSD). Methods Echocardiography,right cardiac catheterization and operation on 10 cases with CSSD were retrospectively studied. Results Three in ten patients were diagnosed correctly (30%),missing diagnosis occurred in 7 cases (70%). CSSD were most often associated with persistent left superior vena cava (100%) and atrial septum defect (90%) of them,4 cases with atrioventricular septal defect,5 cases with secundum atrial septum defect or functional single atrium (large secundum atrial septum defect ). All 10 cases had complex congenital heart defect,7 cases with double outlet of right ventricle,tetralogy of Fallot and single ventricle,3 cases with partial atrioventricular septal defect and functional single atrium. Conclusion For improving the detection accuracy of CSSD,we should pay more attention when complex congenital heart disease combined with survival left superior vena cava or atrioventricular septal defect.