Vogel M, Smallhorn J F, Freedom R M, Coles J, Williams W G, Trusler G A
Department of Pediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada.
Am J Cardiol. 1988 Apr 1;61(10):857-60. doi: 10.1016/0002-9149(88)91079-x.
Since 1983, 36 patients with the combination of right ventricular muscle bundles and a perimembranous ventricular septal defect have been studied in our institution to address the incidence of on associated subaortic abnormality. Of that total 32 (88%) had echocardiographic evidence of such an abnormality (29 had a typical subarotic ridge protruding from the crest of the interventricular septum and the remaining 3 had an echodense area in the same location). Surgical confirmation of the presence or absence of a subaortic abnormality was available in 26. There was correlation between the surgical and echocardiographic findings in all patients. A resting Doppler gradient of greater than or equal to 10 mm Hg was present in only 10. During the study period, 6 patients had Doppler evidence of progression of their gradient. The incidence of subaortic abnormalities in right ventricular muscle bundles and ventricular septal defects appears to be far greater than previously suspected. The exact significance of this finding in the absence of a pressure gradient is still unclear.
自1983年以来，我院对36例合并右心室肌束和膜周部室间隔缺损的患者进行了研究，以探讨相关主动脉瓣下异常的发生率。在这36例患者中，32例（88%）有超声心动图证据显示存在此类异常（29例有典型的主动脉瓣下嵴从室间隔嵴部突出，其余3例在同一位置有回声增强区）。26例患者有手术证实是否存在主动脉瓣下异常。所有患者的手术和超声心动图检查结果均具有相关性。仅10例患者静息状态下多普勒压差≥10 mmHg。在研究期间，6例患者有多普勒证据显示其压差有进展。右心室肌束和室间隔缺损合并主动脉瓣下异常的发生率似乎远高于先前的推测。在无压差情况下这一发现的确切意义仍不清楚。
