超声心动图诊断左冠状动脉异常起源于肺动脉的临床价值

Clinical value of echocardiography in the diagnosis of anomalous origin of left coronary artery from pulmonary artery

目的探讨超声心动图在诊断左冠状动脉异常起源于肺动脉(ALCAPA)中的临床价值。方法回顾分析我院经手术治疗的21例ALCAPA患儿的临床资料,分析术前超声心动图诊断情况,并与术后超声心动图对照;追踪其术后情况。结果21例ALCAPA患儿中,超声心动图首次确诊17例,诊断准确率为81.0%;误诊3例,分别误诊为心内膜弹力纤维增生症、右冠状动脉肺动脉瘘、单纯二尖瓣脱垂合并反流;1例完全性大动脉转位漏诊。21例患儿术后2例死亡,19例好转出院。19例患儿随访3个月至6年,左心收缩功能恢复至正常;15例患儿左心腔大小恢复正常,4例患儿较术前明显缩小;4例患儿二尖瓣中度反流,15例轻度反流。结论超声心动图在ALCAPA术前诊断及术后随访中均具有重要应用价值。

Objective left coronary artery from pulmonary artery(ALCAPA).MethodsThe clinical data of 21 children with ALCAPA treated by surgery in our hospital were analyzed retrospectively.The diagnosis of preoperative echocardiography was analyzed,the results was compared with postoperative echocardiography,and the postoperative follow up was performed.Results with ALCAPA,17 cases were diagnosed by echocardiography for the first time,and the diagnostic accuracy was 81.0%.3 cases were misdiagnosed as endocardial fibroelastosis,right coronary artery pulmonary artery fistula,simple mitral valve prolapse with reflux.1 case of complete transposition of great arteries was missed.2 of 21 cases died after operation,and 19 were discharged after improvement.19 cases were followed up for 3 months to 6 years,the left ventricular systolic function returned to normal,the left ventricular cavity size returned to normal in 15 cases,4 cases were significantly smaller than that before operation.4 cases had moderate mitral regurgitation,and 15 cases had mild regurgitation.ConclusionEchocardiography has important application value in preoperative diagnosis and postoperative follow-up of ALCAPA.