Hu Guobing, Zhu Xiangming, Song Fang
Department of Ultrasound, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China. E-mail.
Saudi Med J. 2017 Apr;38(4):431-434. doi: 10.15537/smj.2017.4.18761.
To retrospectively analyzed the preoperative echocardiographic findings of 9 patients with doubly committed ventricular septal defect (VSD) associated with aortic valve prolapse and to summarize the reasons for misdiagnosis. Methods: This retrospective study was conducted in Yijishan Hospital, Wannan, Anhui, Chinabetween June 2005 and May 2015. Using transthoracic echocardiography (TTE), 92 patients were diagnosed with doubly committed VSD associated with rupture of an aortic sinus aneurysm. The operative findings proved to be in accordance with the echocardiographic findings in 83 patients. Nine patients were confirmed as showing doubly committed VSD associated with perforation of a prolapsed aortic valve. We primarily discussed the 9 patients who were misdiagnosed by TTE. Results: Aneurysm-like protrusions could be detected by 2-dimensional TTE in the right ventricular outflow tract (RVOT) in 9 patients. All of the aneurysm-like protrusions were confirmed by surgery as over-enlarged right coronary leaflets bulging into the RVOT. Conclusion:Occasionally, in patients with doubly committed VSD, aortic valve prolapse can be misdiagnosed as an aortic sinus aneurysm. To reduce the misdiagnosis rate and to provide a more precise preoperative diagnosis, multi-section, and multi-angle observation of these diseases should be performed.
回顾性分析9例双动脉下室间隔缺损（VSD）合并主动脉瓣脱垂患者的术前超声心动图表现，并总结误诊原因。方法：本回顾性研究于2005年6月至2015年5月在中国安徽皖南的弋矶山医院进行。采用经胸超声心动图（TTE），92例患者被诊断为双动脉下VSD合并主动脉窦瘤破裂。手术结果证实83例患者的超声心动图表现与之相符。9例患者被确诊为双动脉下VSD合并脱垂主动脉瓣穿孔。我们主要讨论了9例经TTE误诊的患者。结果：9例患者经二维TTE可在右心室流出道（RVOT）检测到瘤样突出。所有瘤样突出经手术证实为扩大的右冠状动脉瓣叶膨入RVOT。结论：双动脉下VSD患者偶尔可将主动脉瓣脱垂误诊为主动脉窦瘤。为降低误诊率并提供更精确的术前诊断，应对这些疾病进行多切面、多角度观察。
