Mądry Wojciech, Karolczak Maciej Aleksander, Myszkowski Marcin, Zacharska-Kokot Ewa
Department of Cardiac and General Pediatric Surgery, Medical University of Warsaw , Warsaw , Poland.
J Ultrason. 2019;19(76):5-8. doi: 10.15557/JoU.2019.0001.
: To summarize our experience in echocardiographic diagnosis of aortic arch anomalies in pediatric patients. : A retrospective assessment of echocardiographic findings in Echo-Lab patients of the Pediatric Cardiac Surgery Department, who were diagnosed with an anomalous aortic arch between 2003 and 2018. : The diagnosis of an abnormal course of the aortic arch and/or its branches was established in 115 children aged between 4 days and 17 years. The following types of anomalies were detected: left aortic arch with aberrant right subclavian artery in 42 patients; right aortic arch with left brachiocephalic trunk in 14 patients; right aortic arch, aberrant left subclavian artery in 36 patients; double aortic arch in 14 patients; and other, more complex types in 9 patients. The main elements of defects were correctly identified by echo in all cases. We decided to additionally perform computed tomography angiography in 32 patients to clarify all details necessary to qualify patients for surgery and establish the surgical plan. : 1. Echocardiography strictly following the pre-determined protocol has 100% sensitivity in the detection of basic elements of aortic arch anomaly and is a perfect tool for diagnostic process initiation. 2. Since it is not possible to visualize all anatomic details, the qualification for surgery should by based on computed tomography angiography or cardiac magnetic resonance imaging, which precisely visualize both abnormal vessels and compressed structures. : To summarize our experience in echocardiographic diagnosis of aortic arch anomalies in pediatric patients. : A retrospective assessment of echocardiographic findings in Echo-Lab patients of the Pediatric Cardiac Surgery Department, who were diagnosed with an anomalous aortic arch between 2003 and 2018. : The diagnosis of an abnormal course of the aortic arch and/or its branches was established in 115 children aged between 4 days and 17 years. The following types of anomalies were detected: left aortic arch with aberrant right subclavian artery in 42 patients; right aortic arch with left brachiocephalic trunk in 14 patients; right aortic arch, aberrant left subclavian artery in 36 patients; double aortic arch in 14 patients; and other, more complex types in 9 patients. The main elements of defects were correctly identified by echo in all cases. We decided to additionally perform computed tomography angiography in 32 patients to clarify all details necessary to qualify patients for surgery and establish the surgical plan. : 1. Echocardiography strictly following the pre-determined protocol has 100% sensitivity in the detection of basic elements of aortic arch anomaly and is a perfect tool for diagnostic process initiation. 2. Since it is not possible to visualize all anatomic details, the qualification for surgery should by based on computed tomography angiography or cardiac magnetic resonance imaging, which precisely visualize both abnormal vessels and compressed structures.
总结我们在小儿患者主动脉弓畸形超声心动图诊断方面的经验。
回顾性评估2003年至2018年间小儿心脏外科超声实验室中被诊断为主动脉弓畸形的患者的超声心动图检查结果。
在115名年龄在4天至17岁之间的儿童中确诊主动脉弓及其分支走行异常。检测到以下类型的畸形:42例患者为左主动脉弓伴迷走右锁骨下动脉;14例患者为右主动脉弓伴左头臂干;36例患者为右主动脉弓、迷走左锁骨下动脉;14例患者为双主动脉弓;9例患者为其他更复杂的类型。所有病例中超声均正确识别了缺损的主要成分。我们决定对32例患者额外进行计算机断层血管造影,以明确患者手术资格所需的所有细节并制定手术方案。
严格遵循预定方案的超声心动图在检测主动脉弓畸形的基本成分方面具有100%的敏感性,是启动诊断过程的理想工具。
由于无法显示所有解剖细节,手术资格的确定应基于计算机断层血管造影或心脏磁共振成像,它们能精确显示异常血管和受压结构。
总结我们在小儿患者主动脉弓畸形超声心动图诊断方面的经验。
回顾性评估2003年至2018年间小儿心脏外科超声实验室中被诊断为主动脉弓畸形的患者的超声心动图检查结果。
在115名年龄在4天至17岁之间的儿童中确诊主动脉弓及其分支走行异常。检测到以下类型的畸形:42例患者为左主动脉弓伴迷走右锁骨下动脉;14例患者为右主动脉弓伴左头臂干;36例患者为右主动脉弓、迷走左锁骨下动脉;14例患者为双主动脉弓;9例患者为其他更复杂的类型。所有病例中超声均正确识别了缺损的主要成分。我们决定对32例患者额外进行计算机断层血管造影,以明确患者手术资格所需的所有细节并制定手术方案。
严格遵循预定方案的超声心动图在检测主动脉弓畸形的基本成分方面具有100%的敏感性,是启动诊断过程的理想工具。
由于无法显示所有解剖细节,手术资格的确定应基于计算机断层血管造影或心脏磁共振成像,它们能精确显示异常血管和受压结构。