PCHC Department, Institut Jantung Negara, 145, Jalan Tun Razak, Kuala Lumpur, 50400, Malaysia.
Department of Cardiac Surgery, Institut Jantung Negara, 145, Jalan Tun Razak, Kuala Lumpur, 50400, Malaysia.
Cardiol Young. 2023 Nov;33(11):2243-2251. doi: 10.1017/S1047951122004218. Epub 2023 Jan 18.
The objective was to study the ductus arteriosus morphology in duct-dependent pulmonary circulation and its pattern in different ventricle morphology using CT angiography.
From January 2013 to December 2015, patients aged 6 months and below with duct-dependent pulmonary circulation underwent CT angiography to delineate the ductus arteriosus origin, tortuosity, site of insertion, and pulmonary artery anatomy. The ductus arteriosus were classified into type I, IIa, IIb, and III based on its site of origin, either from descending aorta, distal arch, proximal arch, or subclavian artery, respectively.
A total of 114 patients and 116 ductus arteriosus (two had bilateral ductus arteriosus) were analysed. Type I, IIa, IIb, and III ductus arteriosus were seen in 13 (11.2 %), 71 (61.2%), 21 (18.1%), and 11 (9.5%), respectively. Tortuous ductus arteriosus was found in 38 (32.7%), which was commonly seen in single ventricular lesions. Ipsilateral and bilateral branch pulmonary artery stenosis was seen in 68 (59.6%) and 6 (5.3%) patients, respectively. The majority of patients with pulmonary atresia intact ventricular septum had type I (54.4%) and non-tortuous ductus arteriosus, while those with single and biventricular lesions had type II ductus arteriosus (84.9% and 89.7%, respectively). Type III ductus arteriosus was more common in biventricular lesions (77.8%).
Ductus arteriosus in duct-dependent pulmonary circulation has a diverse morphology with a distinct origin and tortuosity pattern in different types of ventricular morphology. CT may serve as an important tool in case selection and pre-procedural planning for ductal stenting.
本研究旨在通过 CT 血管造影术研究依赖动脉导管循环的动脉导管形态及其在不同心室形态中的表现形式。
2013 年 1 月至 2015 年 12 月，对患有依赖动脉导管循环的肺动脉患者行 CT 血管造影术，以描绘动脉导管起源、迂曲、插入部位和肺动脉解剖结构。根据动脉导管起源部位，将其分为 I 型、IIa 型、IIb 型和 III 型，分别来自降主动脉、远端弓、近端弓或锁骨下动脉。
共分析了 114 例患者和 116 条动脉导管（两条为双侧动脉导管）。I 型、IIa 型、IIb 型和 III 型动脉导管分别为 13 例（11.2%）、71 例（61.2%）、21 例（18.1%）和 11 例（9.5%）。38 例（32.7%）存在迂曲的动脉导管，常见于单心室病变。同侧和双侧分支肺动脉狭窄分别见于 68 例（59.6%）和 6 例（5.3%）患者。大多数肺动脉闭锁伴完整室间隔患者为 I 型（54.4%）和非迂曲的动脉导管，而单心室和双心室病变患者分别为 II 型（84.9%和 89.7%）。III 型动脉导管在双心室病变中更为常见（77.8%）。
依赖动脉导管循环的动脉导管形态多样，在不同类型的心室形态中具有不同的起源和迂曲模式。CT 可能是导管支架置入术病例选择和术前规划的重要工具。
