通过计算机断层扫描血管造影明确法洛氏四联症和肺动脉闭锁患者的肺动脉形态和肺供血情况

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiac Surgery Pub Date : 2023-11-15 DOI:10.1155/2023/5511363
N. Pandey, Mumun Sinha, M. Verma, S. Ramakrishnan, Sanjeev Kumar, Priya Jagia
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引用次数: 0

摘要

研究目的本研究旨在通过 CT 血管造影了解法洛氏四联症合并肺动脉闭锁(TOF-PA)患者的肺动脉形态和肺供血情况。材料和方法。我们回顾性审查了本部门的数据库,以确定使用 CT 血管造影术评估的 TOF-PA 患者。对图像进行分析,以检测是否存在主肺动脉、肺动脉分支和肺动脉汇合、是否存在主主动脉肺侧支动脉(MAPCA)、侧位和与肺动脉形态的关系、是否存在动脉导管通畅以及相关的心内和心外异常。结果。177例患者(114例(64.4%)男性;中位年龄:9个月)被确诊为TOF-PA。142/177(80.2%)例患者的肺动脉为汇合型。根据萨默维尔(Somerville)分类法,二型肺动脉闭锁在 127/177 例(71.8%)患者中最为常见。根据麦克古恩比率,123/177(69.5%)例患者的肺动脉足以进行手术。84/177(47.5%)例患者存在动脉导管未闭,而 124(70.1%)例患者存在 MAPCA,其中 72/124(58.1%)例患者至少有一条必要的 MAPCA 供应任一肺。根据先天性心脏病外科医生协会的分类,B 型肺动脉解剖结构在 103/177 例(57.6%)患者中最为常见。结论TOF-PA与肺动脉分支供应肺部的形态显著不同有关。心脏 CT 血管造影可准确描绘 TOF-PA 患者的肺动脉形态、肺供血来源和相关心血管异常,有助于规划适当的手术治疗,包括决定是否需要对 MAPCA 进行单病灶化。
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Clarifying the Pulmonary Arterial Morphology and Pulmonary Blood Supply in Patients with Tetralogy of Fallot and Pulmonary Atresia on Computed Tomography Angiography
Aim. The present study sought to characterize the pulmonary arterial morphology and pulmonary blood supply in patients of tetralogy of Fallot and pulmonary atresia (TOF-PA) on CT angiography. Materials and Methods. We retrospectively reviewed our departmental database to identify patients with TOF-PA evaluated using CT angiography. The images were analysed to detect the presence of main and branch pulmonary arteries and pulmonary arterial confluence, presence of major aortopulmonary collateral arteries (MAPCAs), laterality and relation with pulmonary arterial morphology, and presence of patent arterial duct and associated intra- and extracardiac anomalies. Results. TOF-PA was identified in 177 patients (114 (64.4%) males; median age: 9 months). Pulmonary arteries were confluent in 142/177 (80.2%) patients. According to Somerville classification, type II pulmonary atresia was the most frequent pattern seen in 127/177 (71.8%). Based on McGoon’s ratio, pulmonary arteries were adequate for surgery in 123/177 (69.5%) patients. Patent arterial duct was present in 84/177 (47.5%) patients while MAPCAs were present in 124 (70.1%) patients, of which 72/124 (58.1%) patients had at least 1 essential MAPCA supplying either lung. According to Congenital Heart Surgeons’ Society classification, type B pulmonary arterial anatomy was the most prevalent, seen in 103/177 (57.6%) patients. Conclusion. TOF-PA is associated with marked morphologic variability in the pulmonary arterial arborization to supply the lungs. Cardiac CT angiography can accurately delineate the pulmonary arterial morphology, sources of pulmonary blood supply, and associated cardiovascular anomalies in patients with TOF-PA which aids in planning appropriate surgical management including decisions regarding the need for unifocalization of MAPCAs.
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来源期刊
CiteScore
2.90
自引率
12.50%
发文量
976
审稿时长
3-8 weeks
期刊介绍: Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.
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