Cil E, Saraçlar M, Ozkutlu S, Ozme S, Bilgiç A, Ozer S, Celiker A, Tokel K, Demircin M
Hacettepe University, Medical Faculty, Pediatric Cardiology Department, Ankara, Turkey.
Int J Cardiol. 1995 Jun 2;50(1):19-29. doi: 10.1016/0167-5273(95)02343-u.
The presence of anomalous muscle bundles may produce a pressure gradient between the inflow and outflow portions of the right ventricle, thus resulting in double-chambered right ventricle bearing troublesome clinically in its diagnosis. The aim of the present study was to review the diagnostic criteria. Fifty-two patients with a double-chambered right ventricle were seen during an 8-year period. They ranged in age at the catheterization from 4 months to 17 years (mean 7.5 +/- 4.4 years). Diagnosis was confirmed in 51 patients at cardiac catheterization and in other one on operation. The majority of the patients had associated cardiac anomalies: there were 33 ventricular septal defect (63%), 21 pulmonary valve stenosis (40%), nine atrial septal defect (17%), and four double-outlet right ventricle. The electrocardiograms revealed upright T waves alone in right precordial leads suggesting right ventricular hypertrophy in 33% of the patients. At cardiac catheterization, there was a pressure gradient of 20-160 mmHg between the right ventricular inflow and outflow portions. Forty patients have had surgery and four have undergone balloon pulmonary valvuloplasty. Surgical treatment was planned for two patients and other six had no indication for treatment.
异常肌束的存在可能在右心室的流入和流出部分之间产生压力梯度,从而导致双腔右心室,其临床诊断存在困难。本研究的目的是回顾诊断标准。在8年期间共诊治了52例双腔右心室患者。他们在导管检查时的年龄从4个月到17岁不等(平均7.5±4.4岁)。51例患者经心导管检查确诊,1例经手术确诊。大多数患者伴有心脏异常:室间隔缺损33例(63%),肺动脉瓣狭窄21例(40%),房间隔缺损9例(17%),右心室双出口4例。心电图显示仅右胸前导联T波直立提示右心室肥厚的患者占33%。在心导管检查时,右心室流入和流出部分之间的压力梯度为20 - 160 mmHg。40例患者接受了手术,4例接受了球囊肺动脉瓣成形术。计划对2例患者进行手术治疗,另外6例无治疗指征。