Chaara A, Mesbahi R, Joly P, Abdelali S, Belhaj A S, Maazouzi W, Alaoui A, Bouzoubaa A, Arharbi M, Berrada A
Arch Mal Coeur Vaiss. 1984 Nov;77(12):1411-5.
The authors underline the value of echocardiography in the diagnosis and postoperative management of a case of cor triatrium. The patient was a 22 year old male who presented with dyspnoea of effort (stage III of the NYHA classification) and clinical signs of an infundibulo-pulmonary syndrome with tricuspid regurgitation. Chest X-ray revealed cardiomegaly (CTI = 61%) and filling-in of the aorto-pulmonary window. The electrocardiogram showed left atrial and right ventricular hypertrophy. The echocardiogram, the key to diagnosis, showed an abnormal echogenic structure within the left atrium. Cardiac catheterisation demonstrated pulmonary hypertension and a difference of pressure between the two lungs. The membrane dividing the left atrium and partial anomalous pulmonary venous drainage from the left lung into the superior vena cava were visualised on late stage pulmonary angiography. Surgical excision of the membrane in the left atrium and ligation of the anomalous venous drainage provided a radical cure to all these malformations.
作者强调了超声心动图在三房心病例诊断及术后管理中的价值。该患者为一名22岁男性，表现为劳力性呼吸困难（纽约心脏协会心功能分级III级）以及伴有三尖瓣反流的漏斗部-肺综合征的临床体征。胸部X线显示心脏扩大（心胸指数=61%）及主肺动脉窗填充。心电图显示左心房和右心室肥大。超声心动图作为诊断关键，显示左心房内有异常回声结构。心导管检查显示有肺动脉高压以及两肺之间的压力差。在晚期肺血管造影中可见分隔左心房的隔膜以及左肺部分肺静脉异常引流至上腔静脉。手术切除左心房内的隔膜并结扎异常静脉引流为所有这些畸形提供了根治方法。
