Oberhoffer R, Lang D
Universitätskinderklinik, Sektion Kinderkardiologie, Ulm, F.R.G.
Int J Cardiol. 1989 Nov;25(2):167-71. doi: 10.1016/0167-5273(89)90103-4.
Functional closure of the oval foramen occurs during the first days of life. Nevertheless, range-gated pulsed Doppler echocardiography shows a transatrial flow pattern in many newborns. In this situation, cross-sectional echocardiography often fails in differentiating the valve-incompetent oval foramen from an atrial septal defect. In order to establish Dopplersonographic criteria for these diagnoses, we performed a prospective echocardiographic and pulsed Doppler study in 34 newborns with valve-incompetent oval foramen and in 30 children with atrial septal defect. We could not find any significant difference of flow pattern in either group, although a so-called "flap" signal could be demonstrated in 73.5% of the patients with an oval foramen, but in only 23% of the children with atrial septal defect. We suggest this feature reflects a distinct movement of the flap of oval foramen which passively follows the different interatrial pressure-flow dynamics. Nevertheless, this sign was insufficiently constant to prove presence of an oval foramen and not that specific to exclude an atrial septal defect. We conclude, therefore, that the precise nature of interatrial defects cannot be differentiated by single gate pulsed Doppler echocardiography.
卵圆孔在出生后的头几天发生功能性关闭。然而，距离选通脉冲多普勒超声心动图显示许多新生儿存在经心房血流模式。在这种情况下，横断面超声心动图常常难以区分卵圆孔瓣膜功能不全与房间隔缺损。为了确立这些诊断的多普勒超声心动图标准，我们对34例卵圆孔瓣膜功能不全的新生儿和30例房间隔缺损的儿童进行了一项前瞻性超声心动图和脉冲多普勒研究。尽管在73.5%的卵圆孔患者中可显示出所谓的“瓣叶”信号，但在房间隔缺损儿童中仅为23%，但我们未发现两组中血流模式有任何显著差异。我们认为这一特征反映了卵圆孔瓣叶的独特运动，其被动地跟随不同的心房压力-血流动力学变化。然而，该征象的稳定性不足，无法证实卵圆孔的存在，也不足以特异性地排除房间隔缺损。因此，我们得出结论，单门控脉冲多普勒超声心动图无法区分房间隔缺损的精确类型。
