经胸超声心动图在小儿冠状动脉瘘诊疗中的应用

发布时间：2018-06-02 05:44

本文选题：冠状动脉瘘 + 超声心动描记术　；参考：《中国介入影像与治疗学》2015年10期

【摘要】：目的探讨经胸超声心动图(TTE)在小儿冠状动脉瘘(CAF)诊疗中的价值。方法回顾性分析27例小儿CAF患者,分析其临床症状、TTE检查结果、其他影像学检查结果、治疗方案及随访情况。结果27例CAF患者中,74.07%(20/27)有心脏杂音,14.81%(4/27)有临床症状。7.41%(2/27)出现左心室射血分数减低。55.56%(15/27)的CAF为单纯型;62.96%(17/27)的CAF起源于右冠状动脉,33.33%(9/27)起源于左冠状动脉,而3.70%(1/27)起源于双侧冠状动脉。CAF的瘘道出口可能出现在右心室(13/27,48.15%),肺动脉(6/27,22.22%),右心房(5/27,18.52%),左心室(2/27,7.41%)或冠状静脉窦(1/27,3.70%)。17例患者接受外科手术治疗,1例患者接受介入封堵治疗。TTE精准诊断19例CAF。对于9例接受保守治疗的患者,于诊断后1、3、5年进行随访,未发现自发性闭合、心力衰竭、感染性心内膜炎或死亡病例。结论 TTE安全、有效,可用于筛查、诊断CAF,及评价治疗效果和并发症。
[Abstract]:Objective to investigate the value of transthoracic echocardiography (TTE) in the diagnosis and treatment of coronary artery fistula (CAF) in children. Methods 27 cases of children with CAF were retrospectively analyzed. The clinical symptoms, other imaging findings, treatment plan and follow-up were analyzed. Results among the 27 CAF patients, 74.07% 20 / 27) with a cardiac murmur 14.81% have clinical symptoms .7.41% 2 / 27) the CAF with reduced left ventricular ejection fraction .55.56% 15 / 27) the CAF originates from the left coronary artery in the right coronary artery 33.33992 / 27) and the CAF originates from the left coronary artery. And 3.70 / 27) the fistula outlet of bilateral coronary artery. Caf may appear in 13 / 27 / 48.15 of right ventricle, 6 / 2722.2222 of pulmonary artery, 5 / 27 of right atrium, 18.52 of right atrium, 227 / 7.41 of left ventricle) or 127273.703.70.17 cases of coronary sinus by surgical treatment. One patient received interventional closure. 19 cases of caf were diagnosed accurately by interventional closure. Nine patients who received conservative treatment were followed up for 3 years and 5 years after diagnosis. No spontaneous closure, heart failure, infective endocarditis or death were found. Conclusion TTE is safe and effective. It can be used for screening, diagnosis, and evaluation of therapeutic effect and complications.
【作者单位】：中国医科大学附属盛京医院超声科;中国医科大学附属盛京医院心脏外科;
【基金】：辽宁省科技厅科学技术计划项目(2013225049)
【分类号】：R725.4;R540.45

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