Dzwonczyk T, Davidson W R
Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine 17033, USA.
J Am Soc Echocardiogr. 1995 May-Jun;8(3):263-9. doi: 10.1016/s0894-7317(05)80036-7.
Left ventricular-right atrial communication may be a congenital defect or can result from trauma, endocarditis, or valve replacement. Traditionally the preoperative diagnosis of this entity was made during cardiac catheterization, but recent advances in echocardiography, particularly color Doppler imaging, have greatly facilitated the noninvasive diagnosis of left ventricular-right atrial communication. We present four cases of left ventricular-right atrial communication, each identified by two-dimensional and color Doppler imaging. One case is a congenital defect, two were identified years after cardiac surgery, and one presents as an unusual complication of myocardial infarction. Optimal views for identifying this defect are discussed along with clues to quantifying its hemodynamic significance.
左心室-右心房交通可能是一种先天性缺陷，也可能由外伤、心内膜炎或瓣膜置换引起。传统上，该疾病的术前诊断是在心脏导管检查期间做出的，但超声心动图，尤其是彩色多普勒成像的最新进展，极大地促进了左心室-右心房交通的无创诊断。我们报告4例左心室-右心房交通病例，每例均通过二维和彩色多普勒成像确诊。其中1例为先天性缺陷，2例在心脏手术后数年被发现，1例表现为心肌梗死的罕见并发症。文中讨论了识别该缺陷的最佳视图以及量化其血流动力学意义的线索。
