中国实用儿科杂志

中国实用儿科杂志

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动脉转位术后左心室功能和大动脉发育的中期随访观察

孙勇,贾兵,马晓静,陈张根,张善通,黄国英   

  1. 复旦大学附属儿科医院心血管中心(上海，200032)
  • 收稿日期:2005-01-12 修回日期:2005-05-20 出版日期:2005-08-25 发布日期:2005-08-25

Mid-term follow-up outcome of left ventricle function and size of the great arteries in patients after arterial switch operation.

Sun Yong,Jia Bing,Ma Xiaojing,et al.   

  1. Cardiovascular Center,Children s Hospital,Fudan University,Shanghai 200032,China
  • Received:2005-01-12 Revised:2005-05-20 Online:2005-08-25 Published:2005-08-25

摘要： 目的观察动脉转位术(ASO)治疗复杂先天性心脏病术后早中期超声心动图的随访结果，评价该手术后左心室的功能和大动脉的发育。 方法2000年10月至2004年3月，复旦大学儿科医院对实施ASO后4~37(19.6±11.1)个月的16例患儿进行超声心动图检查，其中室间隔完整的完全性大动脉转位(TGA/IVS)8例，完全性大动脉转位合并室间隔缺损(TGA/VSD)6例，右室双出口合并肺动脉瓣下室间隔缺损(Taussig-Bing畸形)2例。将获取的资料与正常参考值作比较。 结果左室短轴缩短率(LVSF)为(38.10±5.90)%，其中14例(87.5%)在正常范围，2例(12.5%)大于正常范围；左室射血分数(LVEF)为(69.16±7.01)%，均在正常范围。主动脉根部直径平均较正常值扩大(5.5±3.2)mm，其中14例(87.5%)大于正常值95%可信区间的上限；瓣环直径较正常值平均扩大(3.6±3.3)mm，其中10例(62.5%)大于正常值95%可信区间的上限。主肺动脉直径较正常值平均小(1.3±1.5)mm，其中9例(56.25%)在正常值95%可信区间内；瓣环直径较正常值平均小(1.1±1.7)mm，其中10例(62.5%)在正常值95%可信区间内。6例存有主动脉瓣轻度反流；肺动脉瓣上狭窄极轻度3例，轻度狭窄1例；2例存有肺动脉瓣轻度反流。 结论超声心动图随访结果证实目前在本中心开展ASO治疗TGA等复杂性先天性心脏病术后左心室功能良好，新主动脉根部和瓣环有所扩张，新肺动脉根部和瓣环发育良好。

关键词: 完全性大动脉错位, 动脉转位术, 超声心动描计术

Abstract: To evaluate left ventricle function and size of the great arteries after the arterial switch operation (ASO) for transposition of the great arteries (TGA). Methods16 cases with TGA/IVS (n=8),TGA /VSD (n=6) and Taussig Bing abnormality (n=2) were examined at 4~37 months \[(19.6±11.1) m\] after ASO by using M-mode,2D,Doppler and color Doppler echocardiography.The outcome data were compared with normals. ResultsLeft ventricle function was normal in all.Endsystolic diameter of neo-aortic valve annulus and root beyond 95% confidence interval for normal values were in 10 cases (62.5%) and 14 cases (87.5%) respectively.The diameter of neo-pulmonary valve annulus and root in 95% confidence interval for normal values were in 10 cases (62.5%) and 9 cases (56.25%) respectively.Mild aortic regurgitation was observed in 6 cases (37.5%).No correlation was found between aortic and aortic regurgitation dilatation.Neo-aortic stenosis was not observed.Mild supravalvular pulmonary stenosis happened in 4 cases (25.0%),pulmonary regurgitation in 2 cases (12.5%). ConclusionMid-term follow-up after ASO for TGA reveals satisfactory outcome of left ventricle function and dilation of neo-artery root and annular.

Key words: Arterial switch operation, Echocardiography