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[伴有房室瓣或腱索位置异常的大动脉转位:超声心动图表现及手术相关性]

[Transposition of great vessels with position anomaly of the atrioventricular valves or chordae: echocardiographic aspects and surgical correlations].

作者信息

Piot J D, Rey C, Serraf A, Touchot A, Sousa Uva M, Lacour-Gayet F, Planché C

机构信息

Service de chirurgie cardiaque, hôpital Marie-Lannelongue, Le Plessis-Robinson.

出版信息

Arch Mal Coeur Vaiss. 1995 May;88(5):699-704.

PMID:7646280
Abstract

The authors report the echocardiographic appearances of 27 cases of transposition of the great arteries (TGA) with ventricular septal defect (VSD) (including the Taussig-Bing malformation) complicated by displacement of one or both atrioventricular valves and/or chordae tendinae diagnosed between September 1985 and September 1994. An anatomical repair was performed in 21 cases and allowed accurate correlation of the echocardiographic and peroperative findings; a cavo-bipulmonary conduit or a palliative procedure was performed in 6 cases. The cases were classified in 3 groups: group I: 16 children with isolated tricuspid valve abnormalities; group II: 7 cases of mitral valve straddling; group III: 4 cases of displacement of both atrioventricular valves and/or their chordae. The cases of group I were divided into 3 subgroups: subgroup Ia with insertion of the tricuspid chordae on the infundibular septum (7 cases); subgroup Ib with isolated overriding of the tricuspid valve (2 cases); subgroup Ic straddling with or without overriding of the tricuspid valve (7 cases). In all three groups, there were 10 cases of straddling of the tricuspid and 11 cases of straddling of the mitral valve: 9 type A, 3 type B and 9 type C of Tabry's classification. Echocardiography misdiagnosed one case of type A straddling of the tricuspid valve for a type A overriding and straddling of the mitral valve. The ventricular septal defect was situated in the admission septum in the 10 cases of straddling of the tricuspid; in the 11 cases of straddling of the mitral valve the chordae passed through the superior anterior part of the interventricular septum.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

作者报告了1985年9月至1994年9月期间诊断的27例大动脉转位(TGA)合并室间隔缺损(VSD)(包括陶西格-宾畸形),且伴有一个或两个房室瓣和/或腱索移位的超声心动图表现。21例患者接受了解剖修复,从而能够准确对比超声心动图和手术中的发现;6例患者进行了腔静脉-双肺分流术或姑息手术。这些病例分为3组:I组:16例单纯三尖瓣异常的儿童;II组:7例二尖瓣跨立;III组:4例房室瓣及其腱索均移位。I组病例又分为3个亚组:Ia亚组,三尖瓣腱索附着于漏斗间隔(7例);Ib亚组,单纯三尖瓣骑跨(2例);Ic亚组,三尖瓣骑跨伴或不伴骑跨(7例)。在所有3组中,有10例三尖瓣跨立和11例二尖瓣跨立:根据塔布里分类法,9例为A型,3例为B型,9例为C型。超声心动图将1例A型三尖瓣跨立误诊为A型二尖瓣骑跨并跨立。三尖瓣跨立的10例患者中,室间隔缺损位于流入道间隔;二尖瓣跨立的11例患者中,腱索穿过室间隔的上前部。(摘要截断于250字)

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Arch Mal Coeur Vaiss. 1995 May;88(5):699-704.
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