Aoyagi S, Kawara T, Maruyama H, Kosuga T, Akasu K, Yokose S
Department of Surgery, Kurume University School of Medicine, Japan.
Kurume Med J. 1998;45(4):355-9. doi: 10.2739/kurumemedj.45.355.
A 19-month-old male infant with Down syndrome was referred for investigation of heart murmur. An electrocardiogram showed normal axis (+100 degrees) of the QRS complex, incomplete right bundle branch block, and biventricular hypertrophy. Echocardiography revealed a ventricular septal defect (VSD) and a cleft of the anterior mitral leaflet with mild value regurgitation. The anterior mitral leaflet and the septal tricuspid leaflet attached to the same level of the ventricular septum were also delineated, however, no atrial septal defects were detected. Cardiac catheterization demonstrated pulmonary hypertension and a left to right shunt at the right ventricle. During operation, no defects in the atrial septum and no cleft of the septal tricuspid leaflet were found. Cleft of the anterior mitral leaflet, continuity between the mitral anterior leaflet and the tricuspid septal leaflet, and a VSD of the atrioventricular canal type were confirmed. The cleft of the anterior mitral leaflet and the VSD were repaired with the aid of cardiopulmonary bypass. The patient recovered uneventfully.
一名19个月大的患有唐氏综合征的男婴因心脏杂音前来接受检查。心电图显示QRS波群电轴正常（+100度）、不完全性右束支传导阻滞以及双心室肥厚。超声心动图显示室间隔缺损（VSD）以及二尖瓣前叶裂伴轻度瓣膜反流。还描绘出了附着于室间隔同一水平的二尖瓣前叶和三尖瓣隔叶，但未检测到房间隔缺损。心导管检查显示有肺动脉高压以及右心室水平的左向右分流。手术过程中，未发现房间隔缺损以及三尖瓣隔叶裂。证实存在二尖瓣前叶裂、二尖瓣前叶与三尖瓣隔叶的连续性以及房室管型室间隔缺损。在体外循环辅助下修复了二尖瓣前叶裂和室间隔缺损。患者顺利康复。
