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[儿童及青年成人的瓦尔萨尔瓦窦动脉瘤。附9例报告]

[Aneurysm of the sinus of Valsalva in children and young adults. Apropos of 9 cases].

作者信息

Rey C, Leroy O, Francart C, Marchand X, Ducloux G, Dupuis C

出版信息

Arch Mal Coeur Vaiss. 1986 May;79(5):668-75.

PMID:3092766
Abstract

Nine cases (7 boys and 2 girls) of aneurysm of the sinus of Valsalva (SVA) diagnosed before 19 years of age are reported. Group 1 comprised 5 children aged 5 to 14 years without rupture of the aneurysm; 3 had an associated ventricular septal defect (VSD). The diseased sinus was the right anterior sinus in 4 cases and the posterior sinus in one case. The diagnosis was made by 2D echocardiography, performed in 3 patients for follow-up of a VSD and in 2 patients to investigate a systolic murmur. Group 2 comprised 4 patients under 19 years of age with SVA which ruptured into in the right heart cavities. One of these patients had a known right anterior SVA diagnosed at angiography performed to investigate a VSD when the child was 4 years old. The rupture occurred suddenly when the child was 14. These cases of SVA involved the right anterior sinus with rupture into the right ventricle (3 cases) and the posterior non-coronary sinus with rupture into the right atrium (1 case). A rupture syndrome was observed in 3 of the 4 patients with pulmonary oedema in 2 cases. The authors emphasise the rarity of SVA diagnosed before rupture and the low frequency of rupture before adulthood. Echocardiography is certainly the best method for diagnosing the condition and for following up these patients.

摘要

本文报告了9例19岁前诊断为瓦氏窦瘤(SVA)的病例(7例男孩,2例女孩)。第1组包括5名年龄在5至14岁之间的儿童,其动脉瘤未破裂;3例伴有室间隔缺损(VSD)。病变窦在4例中为右前窦,1例为后窦。诊断通过二维超声心动图做出,3例用于VSD随访,2例用于调查收缩期杂音。第2组包括4例19岁以下SVA破裂进入右心腔的患者。其中1例患者在4岁时因调查VSD行血管造影时诊断为已知的右前SVA。14岁时突然发生破裂。这些SVA病例累及右前窦并破裂入右心室(3例),后无冠状窦破裂入右心房(1例)。4例患者中有3例出现破裂综合征,2例出现肺水肿。作者强调SVA在破裂前诊断罕见,成年前破裂频率低。超声心动图无疑是诊断该病及随访这些患者的最佳方法。

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