【与主动脉病理相关的大血管完全转位的心血管造影和超声心动图诊断】。

Grudnaia khirurgiia (Moscow, Russia) Pub Date : 1989-11-01
B G Alekian, V A Garibian, A P Nikoliuk, G A Zubkova, M A Nasedkina
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引用次数: 0

摘要

本文分析了婴儿完全性大血管转位(CTGV)主动脉病变的诊断经验。350例患者中有9例(2.6%)出现主动脉病变。CTGV患者有6例主动脉缩窄,2例主动脉下狭窄,1例主动脉弓完全中断。我们的经验证明,二维超声心动图可以从胸骨上或高右胸骨旁入路定位胸主动脉区域。2例患者在尸检时被诊断为主动脉下狭窄。回顾性分析超声心动图和心血管造影显示主动脉下梗阻的特征性征象。主动脉弓和降主动脉不连续性是主动脉弓中断的超声心动图征象,只有在心血管造影后才被回顾性地认识到。右室和左心室造影必须进行精确的解剖诊断CTGV室间隔完整合并主动脉缩窄。对于合并室间隔缺损的患者,该检查应辅以升主动脉的顺行和逆行主动脉造影,以排除动脉导管未闭,并更好地显示CA。对于所有主动脉弓连续性完全中断的患者,必须进行所有心腔插管、左右心室造影、主动脉造影和肺动脉造影。
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[Angiocardiographic and echocardiographic diagnosis of complete transposition of great vessels in association with pathology of the aorta].

The article analyses experience in the diagnosis of a pathological condition of the aorta in complete transposition of the great vessels (CTGV) in infants. Pathology of the aorta was revealed in 9 (2.6%) of the 350 patients who were examined. Six patients with CTGV had coarctation of the aorta (CA), 2 had subaortic stenosis, and one patient had complete interruption of the arch of the aorta. Our experience provides evidence that two-dimensional echocardiography allows the region of the thoracic aorta to be located from a suprasternal or a high right parasternal approach. Subaortic stenosis was diagnosed in 2 patients during autopsy. Retrospective analysis of the echocardiograms and angiocardiograms revealed characteristic signs of subaortic obstruction. Absence of the continuity of the arch and descending aorta is an echocardiographic sign of interruption of the arch of the aorta which was recognized retrospectively only after angiocardiography. Right and left ventriculography must be performed for precise anatomical diagnosis of CTGV with an intact interventricular septum combined with coarctation of the aorta. In patients with concomitant interventricular septal defect this examination is supplemented by antegrade and retrograde aortography from the ascending aorta to exclude patent ductus arteriosus and for better visualization of CA. Catheterization of all heart cavities, right and left ventriculography, aortography, and pulmonary arteriography must be carried out in all patients with total interruption of the continuity of the arch of the aorta.

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[MEDIASTINAL LEIOMYOMA]. [Surgical treatment of mitral stenosis complicated by massive thrombosis of the left atrium]. [Development of clinical physiology in heart surgery]. [Central hemodynamics during correction of acquired aortic defects without artificial blood circulation]. [Angiocardiographic and echocardiographic diagnosis of complete transposition of great vessels in association with pathology of the aorta].
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