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[与威廉姆斯-贝伦综合征相关的冠状动脉异常。附2例报告]

[Coronary anomalies associated with the Williams-Beuren syndrome. Apropos of 2 cases].

作者信息

Bernard Y, Didier D, Bozio A, Champsaur G, Renaud J C, Maurat J P

出版信息

Arch Mal Coeur Vaiss. 1985 May;78(5):791-5.

PMID:3925925
Abstract

Two coronary artery anomalies associated with the Williams-Beuren syndrome are reported. The first case was a 14 year old child with severe supra-aortic stenosis associated with severe hypoplasia of the ascending aorta; 2 D echocardiography and angiography showed a voluminous aneurysm of the left main coronary artery. Aortoplasty with a patch gave a good early result. The second case was a two and a half months old baby operated as an emergency after cardiac arrest and who died at the end of surgery. The baby had severe supra-aortic stenosis, occlusion of the left coronary ostium by the left anterior cusp which was abnormally adherent to the aortic wall with subendocardial infarction and reaction fibroelastosis. The frequency of coronary anomalies associated with the Williams-Beuren syndrome is probably underestimated. Because of their severity they must be looked for routinely, by echocardiography and angiography. Their tendency to progress is an indication for early surgical correction of severe supra-aortic stenosis.

摘要

本文报告了两例与威廉姆斯-贝伦综合征相关的冠状动脉异常病例。第一例是一名14岁儿童,患有严重的主动脉弓上狭窄并伴有升主动脉严重发育不全;二维超声心动图和血管造影显示左冠状动脉有巨大动脉瘤。采用补片进行主动脉成形术取得了良好的早期效果。第二例是一名两个半月大的婴儿,在心脏骤停后作为急诊进行手术,术后死亡。该婴儿患有严重的主动脉弓上狭窄,左冠状动脉口被异常附着于主动脉壁的左前瓣叶阻塞,伴有心内膜下梗死和反应性纤维弹性组织增生。与威廉姆斯-贝伦综合征相关的冠状动脉异常的发生率可能被低估了。由于其严重性,必须通过超声心动图和血管造影进行常规检查。它们的进展趋势提示对于严重的主动脉弓上狭窄应尽早进行手术矫正。

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