儿童主动脉瓣二叶畸形的超声心动图特征分析

Echocardiographic features of bicuspid aortic valve in children

目的分析儿童主动脉瓣二叶畸形(BAV)的超声心动图特征。方法回顾性分析我院143例BAV患儿的临床及超声心动图检查资料,对儿童BAV进行分型,总结其超声心动图特征;比较有、无并发症患儿的临床资料和超声心动图参数的差异。结果143例BAV患儿以Type 1,R-L型最多见(74例),其次为Type 0,lat型(32例)。BAV合并其他先天性心血管畸形64例,以主动脉弓部异常及其复合畸形最多见(21例);单纯BAV 79例,其中50例出现并发症(40例为Type 1型),包括瓣膜损害38例(主动脉瓣狭窄18例),主要表现为轻度狭窄,主动脉受累12例。单纯BAV患儿中,有并发症者与无并发症者的左室射血分数比较差异无统计学意义,左室心肌质量指数比较[(58.6±15.4)g/m^(2)vs.(51.3±13.0)g/m^(2)],差异有统计学意义(P<0.05)。结论儿童BAV最常见的类型为Type 1,R-L型,常合并其他先天性心血管畸形,以主动脉弓部异常及其复合畸形最为常见;单纯BAV可在儿童期出现瓣膜损害及主动脉扩张等并发症,导致其左室心肌发生重构。

Objective To analyze the echocardiographic features of bicuspid aortic valve(BAV)in children.Methods The clinical and echocardiographic data of 143 children with BAV were retrospectively analyzed.The children’s BAV was classified,the echocardiographic features and complication were summarized.The clinical data and echocardiographic parameters of children with and without complications were compared.ResultsThe most common type of BAV was Type 1,R-L type(74 cases),followed by Type 0,lat type(32 cases).A total of 64 cases of BAV were diagnosed combined with other congenital cardiovascular malformations,the most common of which were aortic arch abnormalities and the aortic coarctation complex(21 cases).There were 79 cases of simple BAV,of which 50 cases had complications(40 cases were Type 1).Among the complications,38 cases with valvular damage was included(18 cases of aortic valve stenosis),the main manifestation was mild stenosis,and 12 cases of aortic involvement.In children with simple BAV,there was no significant difference in left ventricular ejection fraction between children with complications and those without complications,the left ventricular myocardial mass index was compared[(58.6±15.4)g/m^(2) vs.(51.3±13.0)g/m^(2),P<0.05],and the difference was statistically significant(P<0.05).ConclusionThe most common type of children with BAV is Type 1,R-L type.Pediatric patients with BAV are often complicated with other congenital cardiovascular malformations,with abnormalities of aortic arch and their compound malformations being the most common.Valve damage and aortic dilatation can occur in children with simple BAV,leading to left ventricular myocardial remodeling.