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共同心室或单心室。42例患者的心血管造影和血液动力学研究。

Common or single ventricle. An angiocardiographic and hemodynamic study of 42 patients.

作者信息

Macartney F J, Partridge J B, Scott O, Deverall P B

出版信息

Circulation. 1976 Mar;53(3):543-54. doi: 10.1161/01.cir.53.3.543.

Abstract

To correlate anatomy with hemodynamics, the angiocardiographic findings were reviewed in 42 patients with common ventricle (CV). Nine had normally related great arteries (NRGA), 12 d-malposition, 21 l-malposition and 5 a common atrioventricular valve. Selective outlet chamber (OLC) angiocardiograms were available in 14 out of 29 patients with OLCs. OLC position varied from anterior and to the right of the CV to posterior and to the left of it; two categories (anterior and lateral OLC) were delineated by a line 45 degrees to theleft of anterior in the horizontal plane. The OLC was anterior in all patients with NRGA, lateral in most l-malpositions, and almost equally divided between anterior and lateral in d-malposition (P less than 0.05). Complete hemodynamic data were obtained in 29 patients. Complete mixing of venous return occurred in four patients with atresia of one valve. In the remainder complete mixing occurred in 36%, unfavorable streaming in 12% and favorable streaming in 52%. Semilunar valve position and pulmonary stenosis did not affect the nature of mixing. Systemic arterial (SA) minus pulmonary arterial O2 saturation was positive and significantly higher in patients with malposition with lateral OLCs than anterior OLCs (P less than 0.001). However 79% of SA O2 saturation variation could be predicted from pulmonary and systemic blood flow alone.

摘要

为了将解剖结构与血流动力学相关联,我们回顾了42例共同心室(CV)患者的心血管造影结果。9例患者的大动脉关系正常(NRGA),12例为右旋心,21例为左旋心,5例有共同房室瓣。29例有流出腔(OLC)的患者中,14例有选择性OLC心血管造影。OLC的位置从CV的前方和右侧到后方和左侧不等;通过在水平面上从前方向左45度的一条线划分出两类(前方和外侧OLC)。在所有NRGA患者中OLC位于前方,在大多数左旋心患者中位于外侧,在右旋心患者中前方和外侧的比例几乎相等(P<0.05)。29例患者获得了完整的血流动力学数据。4例有一个瓣膜闭锁的患者出现静脉血完全混合。其余患者中,36%出现完全混合,12%出现不利血流,52%出现有利血流。半月瓣位置和肺动脉狭窄不影响混合的性质。全身动脉(SA)减去肺动脉血氧饱和度为正值,且外侧OLC的位置异常患者显著高于前方OLC的位置异常患者(P<0.001)。然而,仅根据肺血流和体循环血流就可以预测79%的SA血氧饱和度变化。

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