双左心室入口。形态病理学和外科解剖学]。

L Muñoz Castellanos, S Ramírez, M Kuri Nivon, H C Salinas Sánchez
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摘要

鉴于双入口左心室手术治疗的可能性,本文分析了其基本形态学特征对手术及影像学的重要性。采用分段序列系统对17颗心脏进行了研究。13岁时是孤独的;三个是右旋异构体,一个是左旋异构体。9例房室瓣分离;8例有一个共同的房室瓣膜;跨立于房室瓣膜7例狭窄2例。12颗心脏的初级右心室位于右侧,5颗心脏的初级右心室位于左侧。心室动脉连接不协调是最常见的(7例),其次是心室动脉连接不协调(5例)和双出口右心室(5例)。有5例出现肺狭窄。室间隔没有到达心瓣膜。跨越房室瓣膜的室间隔缺损比完全打开左心室的瓣膜更大,限制了室动脉一致性。手术治疗因这种心脏病的复杂性而异,从心脏分隔到姑息治疗。这种心脏畸形的形态学知识是正确解释诊断成像的基础。
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[Double inlet left ventricle. Morphopathology and surgical anatomy].

Because of the possibility of surgical treatment of double inlet left ventricle, its basic morphologic features of surgical and imaging importance are analyzed. Seventeen hearts were studied with the segmental sequential system. The situs was solitus in thirteen; dextroisomerism in three and levoisomerism in one. The atrioventricular valves were separated in nine; there was a common atrioventricular valve in eight; straddling of the atrioventricular valve in seven and stenosis in two. The rudimentary right ventricle was to the right side in twelve hearts and to the left side in five. The discordant ventriculoarterial connection was the most frequent (seven), followed by the concordant one (five) and double outlet right ventricle (five). There was pulmonary stenosis in five. The ventricular septum did not reach the crux cordis. The ventricular septal defect was bigger in straddling atrioventricular valves than in valves completely open into the left ventricle, being restrictive in ventriculoarterial concordance. Surgical treatment varies as the complexity of this cardiopathy does, from cardiac septation to palliation procedures. The morphologic knowledge of this cardiac malformation is basic to interpret correctly the diagnostic imaging.

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