经胸超声心动图在左冠状动脉异常起源于肺动脉的诊断及随访中的应用

目的:探讨经胸超声心动图(TTE)在左冠状动脉异常起源于肺动脉(ALCAPA)的诊断及随访中的应用价值.方法:收集18例ALCAPA患儿的临床资料,分析TTE的诊断符合率及典型征象,随访6个月后,分析术前及术后左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)及二尖瓣反流情况.结果:18例中,TTE正确诊断1...

Application of transthoracic echocardiography in the diagnosis and follow-up of anomalous left coronary artery from the pulmonary artery

Objective:To investigate the value of transthoracic echocardiography(TTE)in the diagnosis and follow-up of anomalous left coronary artery from the pulmonary artery(ALCAPA).Methods:Clinical data of 18 children with ALCAPA were collected,and the diagnostic coincidence rate and typical signs of TTE were analyzed.6-month short-term follow-up was conducted to analyze the preoperative and postoperative left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),and mitral regurgitation.Results:The coincidence rate of TTE diagnosis in 18 cases was 77.8%(14/18),including 6 cases of infantile type and 8 cases of adult type of ALCAPA,the misdiagnosis rate was 16.7%(3/18),and the missed diagnosis rate was 5.5%(1/18).The typical manifestations of TTE were left coronary artery openings in the pulmonary artery wall,thickening and prolapse of the mitral valve and subvalvular tendinous cord,continuous flow reflux into the pulmonary artery at diastole,and enlargement of the left ventricle.Compared with infant ALCAPA,right coronary artery diameter of adult ALCAPA was wider and LVEF was higher preoperativelly(P<0.05).The LVEF of infant ALCAPA at 6 months after surgery was significantly higher than that before surgery,but still lower than that of adult ALCAPA(P<0.05).LVEDD of both types were significantly smaller than those before surgery(P<0.05),but there was no statistically significant difference between the two types after surgery(P>0.05).There were no significant differences in mitral regurgitation between the two types before and after operation(P>0.05).Conclusions:TTE has the advantages of noninvasive,convenient operation and low cost,and has important clinical value in preoperative diagnosis and postoperative follow-up of ALCAPA.