Hoffman P, Wójcik A W, Rózański J, Siudalska H, Jakubowska E, Włodarska E K, Kowalski M
Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland.
Heart. 2004 Jul;90(7):789-93. doi: 10.1136/hrt.2003.017137.
To evaluate the utility of echocardiography in diagnosing double chambered right ventricle (DCRV) in adults.
A retrospective study.
Department of Congenital Heart Diseases and Department of Cardiac Surgery, Institute of Cardiology, Warsaw, Poland.
32 patients, mean age 32.5 years, 21 female, and 11 male.
Transthoracic (TTE) and transoesophageal (TOE) echocardiographic examination in patients with suspected DCRV.
Direct inspection during surgical treatment of 28 patients diagnosed as having DCRV as an isolated lesion or associated with other pathologies.
Echocardiography allowed the final diagnosis of DCRV in 26 patients (81%) out of 32 studied. TTE was diagnostic in 5 (15.6%) whereas TOE was diagnostic in 21 of 21 studied by this technique. Of 6 patients with negative TTE, DCRV was identified by cardiac catheterisation in 3 and directly during surgery in the remaining 3. Of 26 patients diagnosed by echocardiography, the anomalous muscle bundle was discrete in 20 (77%) and diffuse in 6 (23%). In 23 patients (88%) right ventricular outflow obstruction was localised low in the right ventricle, and in the remaining 3 (11.5%), the obstruction was localised high in the right ventricle. Abnormal bundles localised high were discrete, bundles localised in the lower part of right ventricle were discrete in 17 (74%) and diffuse in the remaining 6 (26%). DCRV was an isolated lesion in only 2 patients (6.2%). In all subjects surgical inspection confirmed echocardiographic data.
Echocardiography was very useful to diagnose DCRV in adults as well as to identify its anatomic type. Comparing two different approaches, TOE better defines the entire scope of pathology, including estimation of the resultant systolic pressure gradient within the right ventricular cavity.
评估超声心动图在诊断成人双腔右心室（DCRV）中的效用。
一项回顾性研究。
波兰华沙心脏病学研究所先天性心脏病科和心脏外科。
32例患者，平均年龄32.5岁，女性21例，男性11例。
对疑似DCRV的患者进行经胸（TTE）和经食管（TOE）超声心动图检查。
对28例诊断为孤立性病变或合并其他病变的DCRV患者进行手术治疗时的直接观察。
在32例研究对象中，超声心动图最终确诊26例（81%）DCRV。TTE确诊5例（15.6%），而在采用该技术检查的21例患者中，TOE确诊21例。6例TTE检查结果为阴性的患者中，3例通过心导管检查确诊为DCRV，其余3例在手术中直接确诊。在26例经超声心动图确诊的患者中，异常肌束离散型20例（77%），弥漫型6例（23%）。23例（88%）患者右心室流出道梗阻位于右心室低位，其余3例（11.5%）梗阻位于右心室高位。高位异常肌束为离散型，位于右心室下部的肌束离散型17例（74%），弥漫型6例（26%）。DCRV仅在2例患者（6.2%）中为孤立性病变。所有患者的手术检查均证实了超声心动图数据。
超声心动图在诊断成人DCRV及其解剖类型方面非常有用。比较两种不同方法，TOE能更好地确定整个病理范围，包括评估右心室内产生的收缩期压力梯度。
