Seward J B, Tajik A J, Hagler D J, Ritter D G
Mayo Clin Proc. 1978 Feb;53(2):100-12.
Standard M-mode and contrast echocardiographic features of 35 patients with tricuspid atresia are reported. These features included a single posteriorly located atrioventricular valve with large excursion, often demonstrating the pattern of systolic prolapse, mitral semilunar valve continuity, and small right ventricular chamber. Left ventricular dimension and left ventricular posterior wall thickness were usually increased. Ventricular septal and posterior wall excursion and percent thickening of the left ventricular posterior wall were in the normal range in most cases. However, fractional shortening of the left ventricular minor diameter was below normal in most patients (26/29, 90%) regardless of the age at presentation. A characteristic and reproducible flow pattern of contrast medium was also observed. After systemic venous injection of indocyanine green, the resultant echoes initially appeared in the left atrium and subsequently, via the mitral valve funnel, appeared in the left ventricular cavity. If a small right ventricular chamber could be recorded, this chamber filled with subsequent systole except in patients with intact ventricular septum. With the use of these M-mode echographic features, along with contrast studies, diagnosis of tricuspid atresia can confidently be established at the bedside and can readily be distinguished from other cyanotic congenital defects.
报告了35例三尖瓣闭锁患者的标准M型和对比超声心动图特征。这些特征包括单个位于后方的房室瓣，活动幅度大，常显示收缩期脱垂模式、二尖瓣半月瓣连续性以及小的右心室腔。左心室大小和左心室后壁厚度通常增加。大多数情况下，室间隔和后壁活动以及左心室后壁增厚百分比在正常范围内。然而，无论就诊时年龄如何，大多数患者（26/29，90%）左心室短径缩短分数低于正常。还观察到一种特征性且可重复的造影剂流动模式。经体静脉注射吲哚菁绿后，产生的回声最初出现在左心房，随后通过二尖瓣漏斗出现在左心室腔。如果可以记录到小的右心室腔，除室间隔完整的患者外，该腔室在随后的收缩期充盈。利用这些M型超声心动图特征以及对比研究，在床边即可可靠地诊断三尖瓣闭锁，并且可以很容易地与其他青紫型先天性缺陷区分开来。
