[持久的公共主干。]25例标本的解剖病理研究[j]。

L Muñoz Castellanos, M Kuri Nivón, C A Vázquez Antona
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引用次数: 0

摘要

为了解其病理特征及相关异常,采用节段序贯系统对25例有主干的心脏进行了研究。解剖-胚胎学相关性是为了了解这种畸形的病理复杂性。结果:I型干(96%),室间隔缺损(96%),截断瓣发育不全(28%),室间隔褶(92%),左冠状动脉起源于干后壁(75%),右冠状动脉起源于前壁(96%),冠状动脉起源于四尖瓣对侧Valsalva窦;双心室主干连接平衡的比例为60%,主要分布在右心室(16%)或左心室(16%)。相关异常包括右主动脉弓、主动脉弓中断、左锁骨下动脉起源异常、血管环、Valsalva窦动脉瘤、肺动脉左支缺失。发育上的共同干被解释为胚胎心脏的干隔分离失败;神经嵴细胞的迁移阻滞与Di George综合征有关。了解共干的解剖特征及其相关异常,为正确解释临床诊断影像学提供形态学依据。
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[Persistent common trunk. Anatamopathological study of 25 specimen].

In order to inform the pathologic features and their associated anomalies twenty five hearts with common trunk were studied with the segmental sequential system. An anatomico-embryological correlation was made to understand the pathological complex of this malformation. The results were: type I truncus (96%), infundibular ventricular septal defect (96%), displastic truncal valve (28%), ventriculo infundibular fold (92%), left coronary artery arising from the posterior wall of the truncus (75%), right coronary artery arising from their anterior wall (96%), coronary arteries arising from opposite Valsalva sinuses in the tetracuspid valves; the biventricular conection of the truncus was balanced in 60%, prevailing on the right (16%) or on the left (16%) ventricles. Among the associated anomalies there were right aortic arch, interruption of the aortic arch, anomalous origin of the left subclavian artery, vascular ring, aneurysm of the sinus of Valsalva, and absence of the left branch of the pulmonary artery. Developmentally common trunk is explained as a failure of truncoconal septation in the embryonic heart; a migration arrest of neural crest cells is implicated in the Di George syndrome. Knowledge of the anatomic features of common trunk and their associated anomalies, provides the morphological basis to interpret correctly the clinical diagnostic imagenology.

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