左心室憩室超声心动图特征

Echocardiography features of left ventricular diverticulum

目的 探讨左心室憩室的超声心动图特征和分型。方法 经超声心动图检查发现左心室局限性向外膨出 7例 ,4例进行了冠状动脉造影 ,3例进行了左心室造影。结果 左心室憩室的超声心动图特征是局部左心室壁变薄 ,心室腔局限性向外膨出 ,口较小 ,体部较宽较深。肌性憩室壁保持正常收缩运动 ,纤维性憩室壁与室壁瘤相似 ,无收缩运动。 4例患者冠状动脉造影未见异常 ,左心室造影显示 2例患者左心室憩室或局限性室壁瘤。除先天性左心室憩室外 ,瓣周脓肿造成的局部组织薄弱也是左心室憩室形成的原因。结论 超声心动图探测左心室憩室可能较心室造影优越 ,对鉴别肌性和纤维性憩室有重要意义。由于纤维性左心室憩室有破裂的危险 。

Objective To discuss echocardiographic features and classification of left ventricular diverticulum.Methods Echocardiography demonstrated the saccular evagination of the ventricular wall in 7 patients. Coronary angiography and left ventriculography were performed respectively in 4 and 3 patients. Results Echocardiographic characteristics of the left ventricular diverticulum were the saccular evagination of the left ventricular wall with the neck of the diverticula being smaller than the body. The saccular wall of contractile muscular diverticulum remained a normal motion and was thinner than the normal wall. The saccular wall of the fibrous diverticulum was,due to a loss of myocardial thickness, as thin as aneurysm with a dyskinetic motion. Coronary angiography was normal in all 4 patients. Left ventriculography demonstrated only the saccular evagination of the ventricular wall in 2 patients. Conclusions Echocardiography is superior to ventriculography in the detection of left ventricular diverticulum. Except for congenital left ventricular diverticulum, tissue weakness caused by perivalvular abscess of aortic position of prosthetic heart valve may result in left ventricular diverticulum. It seems legitimate to operate on fibrous diverticulum for the risks of rupture.