经胸和经食道超声心动图评价成人部分型肺静脉异位连接

Partial anomalous pulmonary venous connection evaluated by transthoracic and transesophageal echocardiography in adults

目的通过经胸和经食道超声心动图对研究对象进行全面检查,探讨部分型肺静脉异位连接(partialanomalous pulmonary venous connection,PAPVC)的解剖学特征及其与手术的相关性。方法对2008年6月至2011年7月36例(男12例,女24例,年龄15～59岁,中位年龄37岁)经外科手术证实的先天性PAPVC患者的临床资料进行回顾性分析,所有患者均行经胸超声心动图检查,27例进一步行经食道超声心动图检查,所得诊断结果与外科手术诊断结果进行比较。结果 36例PAPVC均为右肺静脉异位连接,其中两条右肺静脉21例(58.3%),单纯右上肺静脉11例(30.5%),单纯右下肺静脉4例(11.1%)。合并静脉窦型缺损33例(91.6%)。经胸及(或)经食道超声心动图联合检查,与手术结果对比,正确诊断PAPVC 31例(86.1%)。结论超声心动图在对PAPVC的诊断中起到重要作用,为外科术前提供足够的信息,可作为PAPVC诊断的首选检查方法。

Objectives To discuss anatomical features of partial anomalous pulmonary venous connection （PAPVC） on the basis of comprehensive transthoracic （TTE） and transoesophageal echocardiography （TEE） examination and its relation to surgical data. Methods From June 2008 to July 2011, 36 patients （12 men, 24 women, age 15-59 years,average age 37 years）with PAPVC who underwent TFE before surgical repair were included in our study, and 27 of them were furtherly checked by TEE. Records of these patients were retrospectively reviewed and compared with surgical assessments. Results TYE and （or） TEE showed partial anomalous right pulmonary venous connecton in all of 36 cases, including 2 anomalous right pulmonary venous connection in 21 （58.3%） patients, anomalous fight upper pulmonary venous connection in 11 30.9% cases and anomalous right lower pulmonary venous connection in 4 （11.1% ）subjects. Thirty three （91.6%） patients had a sinus venosus atrial defect. Compared with surgical assessments,31 （86%）patients with PAPVC were accurately diagnosed by TTE and/or TEE. Conclusions Eehocardiography is an important examination in evaluation of PAPVC in adults, and affords enough informations for surgery, so it can be the best examination to dignose PAPVC.