大动脉转位亚型与复合性畸形和异常血流动力学之间的关系(附40例分析)

A Study of Sub-types of Transposition of the Great Arteries and Complex Cardiovascular Anomalies and Abnormal Hemodynamics(Report of 40 Cases)

目的:研究大动脉转位(TGA)的亚型与复合性畸形和异常血流动力学之间的关系。材料和方法:应用多普勒超声与导管或手术资料对比研究40例 TGA 类型和袢转方位与复合性畸形和血流动力学类型之间的关系。结果:完全型TGA 单心室、两腔心、PDA 和≥3种畸形的发生率较不完全型和矫正型者增高,袢转方位 L 型与 D 型相当;而后两型分别以 D 型和 L 型为主。D 型左室发育不良、DORV 及高压分流的发生率较 L 型增高或显著增高;而肺动脉狭窄和高阻分流者则显著降低。结论:TGA 类型和方位与某些复合畸形和异常血流动力学存在特定的关系。

Purpose:To Study the relation between classification of transposition of the great artery(TGA)and complex cardiovascular anomalies(CCA)and abnomal hemodynamics.Materials and Methods:40 patients with classification and loop orientation of TGA and CCA and hemodynamic types were studied by comparison of Doppler echocardiography with catheter and/or surgical data in this paper. Results:Incidence of levo-loop(L-TGA)of complete TGA(TGAcom)was basically same with dextro-loop(D-TGA),but an higher inci- dence of D-TGA types in incomplete TGA(TGAin)and L-TGA types in correct TGA(TGAcor)was found respectively.There were higher incidence of single ventricle(SV),cot biloculare(CB),patent ductus arterisus(PDA)and ≥3 kinds of anomalies exited in same patient in TGAcom than those in TGAin and TGAcor.Incidence of hypoplastic left heart syndrome,double outlet right ventricle(DORV) and shunt with high pulmonary pressure in D-TGA were higher or significantly higher than those in L-TGA but incidence of pulmonary stenosis and shunt with high pulmonary resistence in D-TGA signifcantly lower than those in L-TGA.Conclution:An intrinsic link existed between the sub-types and orientations of TGA and certain complex anomalies and abnormal hemodynamics.