Suárez Cabrera P, Baño Rodrigo A, Quero Jiménez M
An Esp Pediatr. 1977 Dec;10(12):905-12.
Eleven cases of atrial septal defect, ostium secundum, with important symptomatology, under the age of one year are reported. The clinical picture does not differ essentially from what is found in older patients. Extracardiac associated anomalies are frequent. Pulmonary to systemic flow ratio varied between 1.3 and 3.5. The E.C.G. showed typical findings is most of the cases, but unexpected left ventricular enlargement was found in one case, and in another one with a Noonan syndrome, a left anterior hemiblock was present. Surgery was performed in six patients, between one and six years. In all, direct vision of the defect showed the large size of it. Pulmonary vascular resistances were normal. It is postulated that early vasodilatation of the pulmonary vascular bed could be the origin of the early onset of a left to right shunt in this patients without an increase in pulmonary vascular resistances.
报告了11例一岁以下具有重要症状的继发孔型房间隔缺损病例。临床表现与老年患者基本无异。心外相关异常较为常见。肺循环与体循环血流量之比在1.3至3.5之间。大多数病例的心电图显示典型表现,但有1例出现意外的左心室扩大,另1例患有努南综合征,存在左前分支阻滞。6例患者在1至6岁之间接受了手术。直视缺损发现其尺寸较大。肺血管阻力正常。据推测,肺血管床的早期血管扩张可能是这些患者在肺血管阻力未增加的情况下早期出现左向右分流的原因。