Yamamoto Iroha, Kaneko Masahiro, Oka Norihiko, Tomoyasu Takahiro, Matsui Kenta
Department of Pediatric and Congenital Cardiovascular Surgery, Jichi Children's Medical Center Tochigi, Shimotsuke, Japan.
Kyobu Geka. 2024 Sep;77(9):665-671.
Case 1 is a 65-year-old woman with right ventricular outflow tract stenosis due to dyspnea on exertion. Preoperative echocardiography revealed no shunt between the right and left ventricles. After resecting the right ventricular muscle bundle and weaning from cardiopulmonary bypass, transesophageal echocardiography confirmed a shunt between both ventricles. Right ventriculotomy under second cardiopulmonary bypass revealed a ventricular septal defect (VSD) that was closed with an expanded polytetrafluoroethylene patch. Case 2 is a 58-year-old woman with a double-chambered right ventricle due to dyspnea on exertion. Preoperative echocardiography revealed a perimembranous VSD that coexisted;however, the VSD was completely covered by a membranous septal aneurysm, and no shunt appeared between both ventricles perioperatively. If right ventricular outflow tract stenosis/double-chambered right ventricle has been diagnosed in adulthood, the echocardiographic findings could have differed preoperatively and postoperatively. Combined use with other imaging modalities should improve the diagnostic accuracy of congenital heart disease.
病例1是一名65岁女性，因劳力性呼吸困难患有右心室流出道狭窄。术前超声心动图显示左右心室之间无分流。切除右心室肌束并脱离体外循环后，经食管超声心动图证实两心室之间存在分流。在第二次体外循环下进行右心室切开术，发现室间隔缺损（VSD），用膨体聚四氟乙烯补片封闭。病例2是一名58岁女性，因劳力性呼吸困难患有双腔右心室。术前超声心动图显示存在膜周部室间隔缺损；然而，室间隔缺损完全被膜性间隔瘤覆盖，围手术期两心室之间未出现分流。如果在成年期诊断出右心室流出道狭窄/双腔右心室，术前和术后的超声心动图表现可能会有所不同。与其他影像学检查方法联合使用应可提高先天性心脏病的诊断准确性。
