Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea.
Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea.
Heart Vessels. 2023 Nov;38(11):1380-1385. doi: 10.1007/s00380-023-02293-2. Epub 2023 Jul 21.
Left pulmonary artery (LPA) stenosis with acute angulation commonly necessitates surgical revision in the treatment of tetralogy of Fallot (TOF). We investigated the clinical characteristics of acute angulation of the LPA in patients with TOF via computed tomography (CT). Between 2011 and 2022, 160 patients were diagnosed with TOF using CT. After excluding 28 patients due to insufficient records or age, 132 patients were included in the present analysis. The patients were divided into two groups according to the presence or absence of acute angulation of the LPA: group I (TOF with an acute angle of the LPA, n = 53) and group II (TOF without an acute angle of the LPA, n = 79). We retrospectively collected clinical data from electronic medical records. T-tests were used to analyze continuous variables (i.e., age, sex, weight, right ventricular outflow tract [RVOT] pressure on echocardiography, and distance to bifurcation), and Fisher's exact and chi-square tests were used to analyze categorical data (i.e., presence of the right aortic arch, pulmonary arterial atresia/hypoplasia, atrial septal defect [ASD], patent ductus arteriosus [PDA], and pulmonary valve). The groups did not differ significantly in terms of sex, weight, presence of the right aortic arch, pulmonary arterial atresia/hypoplasia, ASD, or distance to the bifurcation. Moreover, there was no significant difference between the presence and absence of PDA (P = 0.057); however, patients in group I were significantly older (143.2 ± 97.8 days) than those in group II (91.1 ± 76.0 days, P = 0.002). Furthermore, RVOT pressure was significantly higher among patients in group I (45.1 ± 22.5 mmHg) than in group II (25.0 ± 12.4 mmHg, P < 0.001). In the current study, acute angulation of the LPA in patients with TOF, as observed on CT, was associated with older age and higher RVOT pressure on echocardiography.
左肺动脉（LPA）狭窄伴锐角通常需要手术修正，以治疗法洛四联症（TOF）。我们通过计算机断层扫描（CT）研究了 TOF 患者 LPA 锐角的临床特征。2011 年至 2022 年，有 160 例患者通过 CT 诊断为 TOF。由于记录不足或年龄原因，排除 28 例患者后，本分析纳入 132 例患者。根据 LPA 是否存在锐角，将患者分为两组：I 组（LPA 锐角，n=53）和 II 组（LPA 无锐角，n=79）。我们从电子病历中回顾性收集临床数据。使用 t 检验分析连续变量（即年龄、性别、体重、超声心动图右心室流出道（RVOT）压力和分叉距离），使用 Fisher 确切检验和卡方检验分析分类变量（即右主动脉弓、肺动脉闭锁/发育不全、房间隔缺损（ASD）、动脉导管未闭（PDA）和肺动脉瓣）。两组在性别、体重、右主动脉弓、肺动脉闭锁/发育不全、ASD 或分叉距离方面无显著差异。此外，PDA 的存在与否（P=0.057）无显著差异；然而，I 组患者明显比 II 组患者年龄更大（143.2±97.8 天）比 II 组（91.1±76.0 天，P=0.002）。此外，I 组患者的 RVOT 压力明显更高（45.1±22.5mmHg）比 II 组（25.0±12.4mmHg，P<0.001）。在本研究中，CT 观察到的 TOF 患者 LPA 锐角与年龄较大和超声心动图上 RVOT 压力较高有关。
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