Vidne B A, Subramanian S, Wagner H R
Circulation. 1976 Jan;53(1):157-61. doi: 10.1161/01.cir.53.1.157.
In patients with transposition of the great arteries (TGA), both the D- and L- forms, an aneurysm of the membranous ventricular septum (AMS) produces subpulmonic stenosis due to the higher right ventricular pressure which forces the aneurysm to protrude into the left ventricular, i.e., subpulmonic, outflow tract. The clinical signs and symptoms, hemodynamic findings as well as surgical results were analyzed in eight patients with TGA and AMS. The presence of an AMS should be suspected from hemodynamic data consisting of a combination of elevated left ventricular pressure, gradient across the left ventricular outflow tract and presence of a small ventricular septal defect with or without pulmonary artery hypertension. The AMS can be demonstrated by a right ventricular injection in the lateral view. The anomaly needs to be corrected at the time of the Mustard procedure. If uncorrected it may lead to postoperative death or progressive obstruction. In the presence of an aneurysm even small ventricular septal defects should be closed by a patch and the aneurysm should be excised.
在大动脉转位（TGA）的患者中，无论是D型还是L型，膜周室间隔动脉瘤（AMS）都会导致肺动脉瓣下狭窄，这是由于右心室压力较高，迫使动脉瘤突入左心室，即肺动脉瓣下流出道。对8例TGA合并AMS患者的临床体征和症状、血流动力学结果以及手术结果进行了分析。当血流动力学数据显示左心室压力升高、左心室流出道存在压差以及存在小室间隔缺损（伴或不伴肺动脉高压）时，应怀疑存在AMS。AMS可通过右心室造影侧位片显示。在Mustard手术时需要纠正这种异常。如果不纠正，可能会导致术后死亡或进行性梗阻。在存在动脉瘤的情况下，即使是小室间隔缺损也应补片修补，并且应切除动脉瘤。
