Shepard T H, Fantel A G, Kapur R P
Department of Pediatrics, School of Medicine, University of Washington, Seattle 98195.
Teratology. 1991 Feb;43(2):113-7. doi: 10.1002/tera.1420430204.
A fetus weighing 947 g was autopsied after prenatal echocardiographic diagnosis of a single ventricular heart. At autopsy a single ventricle was present with a pear-shaped scar in the area presumed to represent the right ventricle. A small stoma from the single ventricle connected to the scar and the pulmonary outflow was obstructed. The left coronary artery was occluded and on histologic examination recanalization was seen. A chromatographic peak which closely eluted with the cocaine metabolite, benzoylecognine, was identified in fetal urine. We postulate that coronary spasm following possible cocaine exposure could have produced an infarct which destroyed the right ventricle. It is possible that this fetal pathology may be one mechanism that leads to single ventricle hearts.
一名体重947克的胎儿在产前经超声心动图诊断为单心室心脏后进行了尸检。尸检发现存在一个单心室，在推测代表右心室的区域有一个梨形瘢痕。单心室有一个小开口与瘢痕相连，且肺动脉流出道受阻。左冠状动脉闭塞，组织学检查可见再通现象。在胎儿尿液中鉴定出一个与可卡因代谢物苯甲酰爱康宁紧密洗脱的色谱峰。我们推测，可能接触可卡因后发生的冠状动脉痉挛可能导致了梗死，进而破坏了右心室。这种胎儿病理情况有可能是导致单心室心脏的一种机制。
