右心室双出口的心血管造影诊断

Angiography of double outlet of right ventricles

目的评价心血管造影对右心室双出口的诊断价值。方法收集11例右心室双出口患者的临床及心血管造影资料并进行回顾性分析。全部患者均行x线、心电图、超声心动图心导管及心血管造影检查。结果所有患者的心血管造影诊断与术后诊断完全相符，符合率为100％。11例主动脉、肺动脉同时显影，两大动脉起自右心室。8例室间隔缺损，3例心内膜垫缺损。其中5例室间隔缺损位于肺动脉瓣下，同时并右冠状动脉异位开口；3例室间隔缺损位于主动脉、肺动脉之间，同时合并左右心房互换、永存左上腔静脉；2例室间隔缺损远离肺动脉和主动脉，肺动脉发育差。另1例心内膜垫缺损合并二尖瓣、三尖瓣重度关闭不全。结论心血管造影对右心室双出口及合并畸形可做出较准确诊断。

Objective To report 11 cases of double outlet of right ventricles and to evaluate the methods of angiography. Methods Angiocardiographies of 11 patients were collected. All patients underwent X-ray film, dec- tro-cardiography,echocardiography, cardiac catheterization and angiocardiography. Results The coincidence rate between angiography and operation was 100%. Angiographies were performed in 11 patients. Both great arteries （A- orta and Pulmonary Artery） originated from the right ventricle in all the cases. 8 patients had ventricular septal defect （VSD） and 3 patients had endocardial cushion defect. Five cases of the VSDs were found under the valve of pulmo- nary artery and were accompanied with anomalous origin of the right coronary artery ; 3 cases of the VSDs were found to be between the aorta and pulmonary artery and were accompanied with position interchange of two atria and persis- tent left superior vena cava; 2 cases of the VSDs were found being away from aorta and pulmonary artery as well as agenesis of pulmonary artery. The last case of the endocrinal cushion defect were accompanied with mitral valve in- sufficiency and severe tricuspid insufficiency. Conclusion outlet of right ventricles and accompanied malformation. Angiography can provide accurate diagnosis of double