完全性大动脉转位合并冠状动脉异常的超声心动图诊断

目的评价多普勒超声心动图诊断完全性大动脉转位(D-TGA)冠状动脉解剖类型的准确性,提高超声心动图的首次检出率。方法经外科手术证实为D-TGA的118例患者为研究对象,回顾性分析其超声心动图表现。结果118例患者中,正常冠状动脉104例(88.1%),异常冠状动脉14例(11.9%)。回旋支发自右冠状动脉、单支右冠状动脉、右冠状窦内两支冠状动脉比较多见。超声诊断正确者6例,占42.8%;误诊4例,占28.6%;不能显示4例,占28.6%。心血管造影明确冠状动脉畸形后,两个医生进行超声检查,正确率可提高至71.4%。结论超声心动图可以比较准确地诊断D-TGA患者的冠状动脉异常,主动脉位于右侧及合并室间隔缺损者易合并冠状动脉畸形。

Echocardiographic diagnosis of anomalous coronary arteriesin complete transposition of great arteries

Objective To evaluate the accuracy of the diagnosis of the proximal coronary artery anatomy in complete transposition of great arteries (D-TGA) by echocardiography, and to improve the initial echocardiographic diagnosis. Methods We retrospectively reviewed echocardiographic diagnosis of 118 children with D-TGA having undergone surgery. Results Of 118 children with D-TGA, 104 cases (88.1%) were typical coronary arteries, 14 cases (11.9%) were anomalous coronary arteries. Left circumflex originated from the right coronary artery, single right coronary, and two separate coronaries originated from the right coronary sinus were the main variations. The coronary artery anatomy was correctly predicted in 6 cases (42.8%), In the 8 remaining patients, coronary artery anatomy was misdiagnosed in 4 cases (28.6%), visualization of the coronary arteries was not enough to allow determination of their anatomy in 4 cases (28.6%). Two cardiologists performed echocardiogram individually after coronary angiography, the accuracy of the consensus diagnosis improved (71.4%). Conclusion Anomalous coronary artery pattern in D-TGA could be accurately diagnosed by echocardiography.