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大动脉简单转位新生儿动脉调转术后主动脉、冠状动脉及左心室功能的血管造影研究

Angiographic study of aorta, coronary arteries, and left ventricular performance after neonatal arterial switch operation for simple transposition of the great arteries.

作者信息

Massin M M, Nitsch G B, Däbritz S, Messmer B J, von Bernuth G

机构信息

Department of Pediatric Cardiology, Rheinisch-Westfälische Technische Hochschule, Aachen, Germany.

出版信息

Am Heart J. 1997 Aug;134(2 Pt 1):298-305. doi: 10.1016/s0002-8703(97)70138-8.

Abstract

This retrospective study attempts to assess the growth pattern of the aorta and the coronary arteries and the left ventricular function approximately 1 year after neonatal arterial switch operation for simple transposition of the great arteries. Seventy-one patients underwent cardiac catheterization and cineangiocardiography an average of 13.5 months after the operation. The diameters of aortic annulus, aorta at different sites, and coronary arteries were compared with normal ranges taken from the literature. Left ventricular systolic performance was also evaluated. Observations included the following: Neoaortic annulus and root were larger than normal, trivial or mild neoaortic regurgitation was frequently observed, and the development of aortic anastomosis was normal. One patient had unexpected coronary occlusion, one had a coronary artery fistula, and two had a hypoplastic left anterior descending coronary artery. Except in one child who underwent an internal mammary bypass graft immediately after anatomic correction, the global left ventricular performance was normal. Six patients had regional wall motion abnormalities. Our midterm results are encouraging, but potential late complications remain concerns that must continue to be evaluated in long-term follow-up studies.

摘要

这项回顾性研究试图评估大动脉调转术治疗单纯性大动脉转位的新生儿术后约1年时主动脉、冠状动脉的生长模式以及左心室功能。71例患者在术后平均13.5个月接受了心导管检查和心血管造影。将主动脉瓣环、不同部位主动脉以及冠状动脉的直径与文献中的正常范围进行比较。同时对左心室收缩功能进行评估。观察结果如下:新主动脉瓣环和根部大于正常,常观察到轻微或轻度新主动脉反流,主动脉吻合口发育正常。1例患者出现意外的冠状动脉闭塞,1例有冠状动脉瘘,2例左前降支冠状动脉发育不良。除1例在解剖矫正后立即进行胸廓内动脉搭桥术的患儿外,整体左心室功能正常。6例患者存在节段性室壁运动异常。我们的中期结果令人鼓舞,但潜在的晚期并发症仍是令人担忧的问题,必须在长期随访研究中持续评估。

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