Cheng C F, Wang J K, Wu M H
Department of Pediatrics, Tzu Chi Buddhist General Hospital, Hualien City, Taiwan, ROC.
Cardiology. 1998;89(2):134-9. doi: 10.1159/000006769.
Ventricular septal defect (VSD) with posterior deviation of the outlet septum is frequently associated with left ventricular outflow obstruction and aortic arch anomalies. In this study, 17 patients with large VSD and posterior deviation of the outlet septum were evaluated. The VSD was further classified into 'high' and 'low' types according to the extension of the VSD; the high-type VSD (8 patients) extended mainly to the outlet or infundibular portion and the low-type VSD (9 patients) extended mainly to the trabecular or inlet portion. Related morphological features, such as outlet septum hypoplasia, muscle bundle between aortic-mitral valve junction, pulmonary artery overriding and aortic arch anomalies, were found more frequently in patients with high-type VSD, while tricuspid valve straddling and outlet septum hypertrophy were found more often in patients with low-type VSD. This classification for VSD with posterior deviation of the outlet septum helps to predict the morphological features of left ventricular outflow tract and aortic arch anomalies.
室间隔缺损（VSD）合并流出道间隔向后偏移常与左心室流出道梗阻及主动脉弓畸形相关。在本研究中，对17例大型VSD合并流出道间隔向后偏移的患者进行了评估。根据VSD的延伸情况，VSD进一步分为“高位”和“低位”型；高位型VSD（8例）主要延伸至流出道或漏斗部，低位型VSD（9例）主要延伸至小梁部或流入部。在高位型VSD患者中，更常发现相关形态学特征，如流出道间隔发育不全、主动脉 - 二尖瓣交界处肌束、肺动脉骑跨及主动脉弓畸形，而在低位型VSD患者中，三尖瓣跨立及流出道间隔肥厚更为常见。这种对合并流出道间隔向后偏移的VSD的分类有助于预测左心室流出道及主动脉弓畸形的形态学特征。
