Battistessa S, Soto B
Department of Surgery and Diagnostic Radiology, University of Alabama Medical Center, Birmingham, AL 35233.
Int J Cardiol. 1990 May;27(2):253-63; discussion 265-7. doi: 10.1016/0167-5273(90)90167-4.
Nineteen patients with double outlet right ventricle and discordant atrioventricular connexion were studied in order to analyze their angiographic anatomy. The discordant atrioventricular connexion was parallel in 18 patients and criss-cross in one. A ventricular septal defect, present in all cases, was perimembranous in ten (50%), muscular in seven (37%), and was part of an atrioventricular septal defect in two. The defect was related spatially to the subaortic outflow in six (29%), to the subpulmonary outflow in 11 (52%), was doubly committed in one and non-committed in two. Long axial and four-chamber views of the ventriculograms were most useful for the angiographic delineation of the basic anatomy of this entity. In patients with abnormally located hearts, variations of the axial views were necessary for proper delineation of the anatomy. It is concluded that modified axial views of ventriculograms are useful for diagnosis of double outlet right ventricle and discordant atrioventricular connexions.
对19例右心室双出口合并房室连接不一致的患者进行了研究，以分析其血管造影解剖结构。18例患者的房室连接不一致为平行型，1例为交叉型。所有病例均存在室间隔缺损，其中10例（50%）为膜周部缺损，7例（37%）为肌部缺损，2例为房室间隔缺损的一部分。该缺损在空间上与主动脉下流出道相关的有6例（29%），与肺动脉下流出道相关的有11例（52%），1例为双开口型，2例为非开口型。心室造影的长轴和四腔心视图对该实体基本解剖结构的血管造影描绘最为有用。对于心脏位置异常的患者，需要改变轴位视图以正确描绘解剖结构。结论是，心室造影的改良轴位视图有助于诊断右心室双出口合并房室连接不一致。
