左冠状动脉异常起源于肺动脉的超声心动图表现

Echocardiographicmanifestationsof anomalous origin of the left coronary artery from the pulmonary artery

目的:分析超声心动图检查左冠状动脉异常起源于肺动脉(Anomalous origin of the left coronary artery from the pulmonary artery,ALCAPA)的超声表现。方法:回顾性分析6例ALCAPA患者的临床资料,采用超声心动图进行诊断,分析成人型和婴儿型的超声表现。结果:6例患者中超声确诊5例(83.33%),均为成人型;提示诊断1例,为婴儿型。成人型的超声表现为左冠状动脉未开口于左冠窦,开口于肺动脉根部;室间隔和部分左室壁探及侧枝循环,室间隔和左室前壁运动减弱,伴有二尖瓣轻度或中度反流。婴儿型的超声表现为心内膜、二尖瓣腱索、乳头肌回声增强,室壁运动整体减弱,伴有二尖瓣中重度反流。结论:超声心动图可明确或提示性诊断ALCAPA,具有重要的临床意义。

Objective： To analyzeechocardiographic manifestationsof anomalous origin of the left coronary artery from the pulmonary artery（ ALCAPA）. Methods： The echocardiographic data of 6 cases of ALCAPA were retrospectively analyzed to find out the echocardiogram features of the adult and infant patients. Results： Among the 6 patients,5 cases of adult ALCAPA were diagnosed by echocardiogram,and 1 case of infant ALCAPA was suggested. The echocardiographic manifestations of the adult ALCAPA included the opening of the left coronary artery at the root of the pulmonary artery rather than the left coronary sinus,collateral circulation in the interventricular septum and partial left ventricular wall,and decreased movements of the interventricular septum and left ventricular anterior wall accompanied by mild or moderate mitral regurgitation. The infant ALCAPA was characterized by echo enhancement in the endocardium,chordae tendineae of the mitral valve and papillary muscles,and generally attenuated ventricular wall motionaccompanied by moderate to severe mitral regurgitation. Conclusions： Echocardiography can clarify or suggest ALCAPA,and has an important clinical significance.