Jiang Guo-ping, Ye Jing-jing, He Jin, Zhao Lei, Peng Xue-hui, He Yu, Yang Xiu-zhen
The Affiliated Childrenos Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2006 Jul;35(4):440-3. doi: 10.3785/j.issn.1008-9292.2006.04.017.
To assess the accuracy of echocardiography in diagnosis of total anomalous pulmonary venous connection (TAPVC).
A combination of suprasternal, parasternal, subcostal and apical views were employed to diagnose TAPVC and to trace the course of the anomalous pulmonary venous connection, the direction of the inter-atrial shunt, enlargement of right atrium (RA) and right ventricle (RV), superior and inferior vena cava. All pediatric patients underwent surgical repair. The results of echocardiography were compared with surgical findings.
A total of 28 consecutive pediatric patients with suspected TAPVC were included in this study. The TAPVC diagnosis was confirmed in 26 cases after surgery, partial anomalous pulmonary venous connection (PAPVC) in one case, and Cor Triatriatum and possible TAPVC in another. The diagnostic accuracy of TAPVC by echocardiography in the study was 92.86%. There were 17 supracardiac TAPVC, 11 intracardiac TAPVC. In all patients, enlargement of the RA and RV, inter-atrial right-to-left shunt via atrial septal defects were documented in parasternal and subcostal views. Common pulmonary vein or four pulmonary vein direct to RA or via coronary sinus to RA were the draining sites of intracardiac TAPVC. The enlargement of left innominate vein-right superior vena cava draining to RA was seen in supracardiac TAPVC.
A combination of suprasternal and subcostal multi-views in echocardiography can increase the diagnostic accuracy of TAPVC in pediatric patients.
评估超声心动图诊断完全性肺静脉异位连接(TAPVC)的准确性。
采用胸骨上、胸骨旁、肋下和心尖等多切面来诊断TAPVC,并追踪异常肺静脉连接的走行、心房水平分流方向、右心房(RA)和右心室(RV)增大情况以及上、下腔静脉情况。所有儿科患者均接受了手术修复。将超声心动图结果与手术所见进行比较。
本研究共纳入28例连续的疑似TAPVC的儿科患者。术后确诊26例为TAPVC,1例为部分性肺静脉异位连接(PAPVC),另1例为三房心合并可能的TAPVC。本研究中超声心动图诊断TAPVC的准确率为92.86%。其中心上型TAPVC 17例,心内型TAPVC 11例。在所有患者中,胸骨旁和肋下切面均显示RA和RV增大,心房水平存在右向左分流。心内型TAPVC的引流部位为共同肺静脉或四条肺静脉直接汇入RA或经冠状静脉窦汇入RA。心上型TAPVC可见左无名静脉 - 右上腔静脉增粗并引流至RA。
超声心动图采用胸骨上和肋下多切面联合检查可提高儿科患者TAPVC的诊断准确性。