主动脉缩窄合并先天性主动脉瓣畸形的超声诊断

Echocardiographic diagnosis of coarctation of aorta combined with congenital aortic valve malformation

目的探讨先天性主动脉缩窄合并主动脉瓣畸形的患病情况及超声心动图的应用。方法回顾性分析41例先天性主动脉缩窄患者及同期我院主动脉瓣畸形手术患者85例的超声心动图资料,统计其中先天性主动脉瓣畸形的患病率。结果 41例先天性主动脉缩窄患者中合并主动脉瓣畸形13例(37.71%)。其中二叶主动脉瓣畸形10例(76.92%),在10例中正斜杠状("\"型排列)5例(50.00%)。先天性三叶主动脉瓣畸形3例(23.08%)。同期先天性主动脉瓣畸形行手术的患者中漏诊2例主动脉缩窄,1例为主动脉弓右降,累及长度较长约4 cm,另1例左室收缩功能减低为38%。结论在进行超声诊断时发现先天性主动脉瓣畸形有助于指导主动脉缩窄的扫查。对于右位主动脉弓、缩窄累及长度及心排量等影响因素在主动脉缩窄的诊断中应引起重视。

Objective To investigate the prevalence and echocardiographic diagnosis of coarctation of aorta（COA） combined with congenital aortic valve malformation（CAVM）. Methods Echocardiography of 41 patients with COA and 85 patients operated for CAVM was analyzed retrospectively. The prevalence rate of CAVM in the 41 patients with COA was recorded. Results Of 13patients（37.71%） with COA and CAVM, the prevalence of bicuspid aortic valve was 76.92%（10 / 13） with 50% ＂／ ＂ type（back slash shape）. The proportion of tricuspid aortic valve was 23.08%（3 / 13）. CAVM in 1 patient with 4 cm long COA and 1 patient with38% left ventricular systolic function was not detected on echocardiography. Conclusion Echocardiography of CAVM should include search for coexistent COA, length of the stenosis and cardiac output.