先天性主动脉瓣下狭窄的超声诊断分析

目的 探讨主动脉瓣下狭窄(SAS)的超声心动图诊断价值.方法 回顾性分析30例SAS的超声心动图特征及手术所见.结果 单纯SAS 9例,其中隔膜型3例,肌肥厚性5例,二尖瓣畸形导致的1例.21例合并有其他心血管畸形,其中室间隔缺损(VSD)6例,动脉导管未闭(PDA)7例,主动脉瓣狭窄(AA)5例、主动脉缩窄(COA)3例.根据三尖瓣反流、心内或大血管水平分流压差,估测肺动脉收缩压52～75mm Hg.2例患者漏诊弥漫型SAS;1例被误诊为肥厚型心肌病(HCM).结论 SAS合并其他心血管畸形在解剖、血流动力学上有许多特异之处,把握其特殊表现,有助于超声心动图做出准确诊断,从而为手术治疗提供有价值的参考.

Analysis of ultrasonic diagnosis in congenital subvalvular aortic stenosis

OBJECTIVE To investigate the diagnostic value of UCG in diagnosing subvalvular aortic stenosis(SAS).METHODS Retrospectively analyzed the UCG features and findings during operations in 30 patients with SAS.RESULTS 9 simple SAS cases,including 3 diaphragm cases,5 muscle hypertrophy cases and 1 mitral valve deformity case.21 cases of other cardiovascular malformation complications,including 6 cases of ventricular septal defect(VSD),7 cases of patent ductus arteriosus(PDA),5 cases of aortic stenosis(AS)and 3 cases of coarctation of the aorta(COA).According to the tricuspid regurgitation and the level bypass pressure difference of heart or great vessels,the pulmonary artery systolic pressure was estimated within 52-75 mm Hg.Two cases were missed diagnosis of diffuse-type SAS;1 was misdiagnosed as hypertrophic cardiomyopathy(HCM).CONCLUSION SAS combined with other cardiovascular malformations have many distinctions in anatomy and hemodynamics.Grasping their special performance is helpful to make an accurate diagnosis by ultrasonic cardiogram so as to provide valuable reference for surgical treatment.