Werho David K, Thorsson Thor, Owens Sonal T, Fifer Carlen
C.S. Mott Congenital Heart Center, University of Michigan, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA,
Pediatr Cardiol. 2015 Aug;36(6):1310-1. doi: 10.1007/s00246-015-1171-z. Epub 2015 Apr 9.
We report a rare case of hypoplastic left heart syndrome coexisting in a patient with Ebstein anomaly of the tricuspid valve, which has previously been described only in pathological studies. A fetal echocardiogram at 27-weeks gestation showed severe aortic stenosis with evolving hypoplastic left heart syndrome, significant endocardial fibroelastosis, a dysplastic tricuspid valve with moderate regurgitation, right atrial and ventricular dilation, and signs of fetal congestive heart failure. Due to inadequate left heart size, the patient was not a candidate for fetal intervention for critical aortic stenosis, and repeat studies showed progression of the lesion through the pregnancy. The infant was delivered at 36-weeks gestation with signs of hydrops, and a postnatal echocardiogram confirmed hypoplastic left heart syndrome as well as severe Ebstein anomaly of the tricuspid valve. The infant did not survive to intervention.
我们报告了一例罕见的病例,即一名患有三尖瓣埃布斯坦畸形的患者同时存在左心发育不全综合征,此前仅在病理学研究中有所描述。妊娠27周时的胎儿超声心动图显示严重主动脉瓣狭窄并伴有逐渐发展的左心发育不全综合征、显著的心内膜弹力纤维增生症、发育异常的三尖瓣伴中度反流、右心房和心室扩张以及胎儿充血性心力衰竭的迹象。由于左心尺寸不足,该患者不适合接受针对严重主动脉瓣狭窄的胎儿干预,重复检查显示病变在整个孕期持续进展。婴儿于妊娠36周时出生,伴有水肿迹象,产后超声心动图证实存在左心发育不全综合征以及严重的三尖瓣埃布斯坦畸形。该婴儿未能存活至接受干预。