Halpern Dan G, Steigner Michael L, Prabhu Sanjay P, Valente Anne Marie, Sanders Stephen P
Adult Congenital Heart Disease and Pulmonary Hypertension Service, Department of Cardiology, Boston Children's Hospital, Boston, Mass, USA.
Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Boston, Mass, USA.
Congenit Heart Dis. 2015 Sep-Oct;10(5):396-402. doi: 10.1111/chd.12243. Epub 2015 Jan 7.
We investigated the type and extent of calcification in a series of heart specimens from adult congenital heart disease patients because recent autopsy observations suggested a high prevalence of calcification.
We used computed tomography to examine seven heart specimens from adults (>18 years old) with a congenital heart defect collected with permission from the family during a recent 3-year period. Clinical data regarding diagnosis, history, and imaging studies were recorded. The 3D data sets were reviewed after reformatting as maximum intensity projection and volumetric renderings to determine the pattern and extent of calcium deposition.
Five of the seven hearts had extensive calcifications in one or more of three patterns: atherosclerosis associated in the three oldest cases; surgery associated in four of five hearts that had undergone heart surgery; and myocardial calcification remote from surgical sites in two cases. Myocardial calcification was associated with regional dysfunction and was present in the three patients that died suddenly and unexpectedly.
Cardiac calcification was frequent in our series of heart specimens from adults with congenital heart defects, was often but not uniformly associated with prior surgery, and, in our small series, was associated with regional dysfunction and sudden death.
我们对一系列成年先天性心脏病患者的心脏标本中的钙化类型和程度进行了研究，因为最近的尸检观察表明钙化的患病率很高。
我们使用计算机断层扫描检查了7例成年（>18岁）先天性心脏病患者的心脏标本，这些标本是在最近3年期间经家属同意收集的。记录了有关诊断、病史和影像学研究的临床数据。在将三维数据集重新格式化为最大强度投影和容积再现后进行回顾，以确定钙沉积的模式和程度。
7例心脏中有5例出现了广泛钙化，呈以下三种模式中的一种或多种：3例年龄最大的病例中出现动脉粥样硬化相关钙化；5例接受过心脏手术的心脏中有4例出现手术相关钙化；2例出现远离手术部位的心肌钙化。心肌钙化与局部功能障碍有关，在3例突然意外死亡的患者中存在。
在我们的成年先天性心脏病患者心脏标本系列中，心脏钙化很常见，通常但并非总是与既往手术有关，并且在我们的小样本中，与局部功能障碍和猝死有关。
