Tongsong Theera, Sittiwangkul Rekwan, Khunamornpong Surapan, Wanapirak Chanane
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
J Clin Ultrasound. 2005 Sep;33(7):367-71. doi: 10.1002/jcu.20142.
Hypoplastic left heart syndrome (HLHS) is a spectrum of fetal conditions associated with severe hypoplasia of the left ventricle and left ventricular outflow tract. The purpose of this series was to focus on the sonographic prenatal features of isolated HLHS. Based on the 5 cases presented here, the prenatal sonographic features of HLHS include small-sized left ventricle, atretic or hypoplastic mitral valves with restricted motion and a small amount of antegrade flow or regurgitation, and hypoplastic ascending aorta. Retrograde flow in the transverse aortic arch strongly suggests inadequate systemic output from the left heart. Tricuspid regurgitation is common and increases the chance for the development of hydrops. Other findings may be helpful, including left ventricular hyperechoic endocardium and increased nuchal translucency at 11-14 weeks. With careful fetal echocardiography, HLHS may be readily observed on a 4-chamber view as either a small or even absent left ventricle.
左心发育不全综合征（HLHS）是一系列与左心室及左心室流出道严重发育不全相关的胎儿疾病。本系列研究的目的是聚焦孤立性HLHS的超声产前特征。基于此处呈现的5例病例，HLHS的产前超声特征包括左心室尺寸小、二尖瓣闭锁或发育不全且活动受限、仅有少量前向血流或反流，以及升主动脉发育不全。主动脉弓横切面的逆向血流强烈提示左心的体循环输出不足。三尖瓣反流很常见，会增加胎儿水肿发生的几率。其他发现可能也有帮助，包括左心室心内膜回声增强以及孕11 - 14周时颈部透明带增厚。通过仔细的胎儿超声心动图检查，在四腔心切面可容易观察到HLHS，表现为左心室小甚至缺如。
