The histopathological characteristics of congenital aortic valve malformations in children were investigated.All the native surgically excised aortic valves from 32 pediatric patients suffering from symptomatic aortic...The histopathological characteristics of congenital aortic valve malformations in children were investigated.All the native surgically excised aortic valves from 32 pediatric patients suffering from symptomatic aortic valve dysfunction due to congenital aortic valve malformations between January 2003 and December 2005 were studied macroscopically and microscopically.The patients’medical records were reviewed and the clinical information was extracted.The diagnosis was made by the clinical presentation,preoperative echocardiography,intraoperative examination,and postoperative histopathological study,excluding rheumatic or degenerative aortic valve diseases,infective endocarditis and primary connective tissue disorders,e.g.Marfan syndrome.Among 32 children with congenital aortic valve malformations,the age was ranged from six to 18 years,with a mean of 14.9 years,and there were 27 boys and five girls(male:female=5.4:1).There were five cases of aortic stenosis(AS,15.62%),25 cases of aortic insufficiency(AI,78.13%)and two cases of AS-AI(6.25%),without other valve diseases.Twenty cases still had other congenital heart diseases:ventricular septal defect(19 cases),patent ductus arteriosus(two cases),double-chambered right ventricle(one case),aneurysm of the right anterior aortic sinus of valsalva(three cases).Histopathological examination indicated that the cusps became thickening with unequal size,irregular shape(coiling and prolapse edge),enhanced hardness,and partly calcification.Microscopic investigation revealed the unsharp structure of valve tissue,fibrosis,myxomatous,reduced collagen fiber,rupture of elastic fibers,different degrees of infiltration of inflammatory cells,secondary calcareous and lipid deposit,and secondary fibrosis.Congenital aortic valve malformations in children involve males more than females,mostly associated with other congenital heart diseases.Aortic insufficiency is more common in children with congenital aortic valve malformations.Histopathologically,the leaflets of aortic valve are mainly myxomatous,thickening with unequal size,irregular shape(coiling and prolapse edge),reduced collagen fiber,rupture of elastic fibers,without small vessel proliferation and inflammatory cell infiltration,fibrosis and calcification rarely seen.展开更多
目的评价经胸二维超声心动图(2DE)、经食道超声心动图(TEE)、经胸三维超声心动图(3DE)在儿童主动脉瓣病变Ozaki手术中的应用价值。方法回顾性分析7例Ozaki手术患者的2DE、TEE、3DE资料特征。结果 7例患者术前均行2DE及3DE检查,与手术结...目的评价经胸二维超声心动图(2DE)、经食道超声心动图(TEE)、经胸三维超声心动图(3DE)在儿童主动脉瓣病变Ozaki手术中的应用价值。方法回顾性分析7例Ozaki手术患者的2DE、TEE、3DE资料特征。结果 7例患者术前均行2DE及3DE检查,与手术结果对比,超声诊断正确7例,占100%;合并单支冠状动脉2例、冠状动脉肺动脉瘘1例,超声检查均漏诊。7例均行术中TEE检查,术后3个月2DE复查,主动脉反流束宽明显减轻(0.64±0.25)cm vs (0.22±0.04)cm,(P<0.01)、左心室舒张末期内径明显减小(5.69±0.45)cm vs (4.50±0.83)cm,(P<0.01)。结论2DE、3DE术前可以显示主动脉瓣的数目、大小、狭窄及反流的程度,比较准确地诊断主动脉瓣病变,但容易漏诊合并的冠状动脉畸形;TEE在术中即刻效果判断、2DE在术后随访中起重要作用,是儿童主动脉瓣病变Ozaki手术安全、有效的监测方法。展开更多
文摘The histopathological characteristics of congenital aortic valve malformations in children were investigated.All the native surgically excised aortic valves from 32 pediatric patients suffering from symptomatic aortic valve dysfunction due to congenital aortic valve malformations between January 2003 and December 2005 were studied macroscopically and microscopically.The patients’medical records were reviewed and the clinical information was extracted.The diagnosis was made by the clinical presentation,preoperative echocardiography,intraoperative examination,and postoperative histopathological study,excluding rheumatic or degenerative aortic valve diseases,infective endocarditis and primary connective tissue disorders,e.g.Marfan syndrome.Among 32 children with congenital aortic valve malformations,the age was ranged from six to 18 years,with a mean of 14.9 years,and there were 27 boys and five girls(male:female=5.4:1).There were five cases of aortic stenosis(AS,15.62%),25 cases of aortic insufficiency(AI,78.13%)and two cases of AS-AI(6.25%),without other valve diseases.Twenty cases still had other congenital heart diseases:ventricular septal defect(19 cases),patent ductus arteriosus(two cases),double-chambered right ventricle(one case),aneurysm of the right anterior aortic sinus of valsalva(three cases).Histopathological examination indicated that the cusps became thickening with unequal size,irregular shape(coiling and prolapse edge),enhanced hardness,and partly calcification.Microscopic investigation revealed the unsharp structure of valve tissue,fibrosis,myxomatous,reduced collagen fiber,rupture of elastic fibers,different degrees of infiltration of inflammatory cells,secondary calcareous and lipid deposit,and secondary fibrosis.Congenital aortic valve malformations in children involve males more than females,mostly associated with other congenital heart diseases.Aortic insufficiency is more common in children with congenital aortic valve malformations.Histopathologically,the leaflets of aortic valve are mainly myxomatous,thickening with unequal size,irregular shape(coiling and prolapse edge),reduced collagen fiber,rupture of elastic fibers,without small vessel proliferation and inflammatory cell infiltration,fibrosis and calcification rarely seen.
文摘目的评价经胸二维超声心动图(2DE)、经食道超声心动图(TEE)、经胸三维超声心动图(3DE)在儿童主动脉瓣病变Ozaki手术中的应用价值。方法回顾性分析7例Ozaki手术患者的2DE、TEE、3DE资料特征。结果 7例患者术前均行2DE及3DE检查,与手术结果对比,超声诊断正确7例,占100%;合并单支冠状动脉2例、冠状动脉肺动脉瘘1例,超声检查均漏诊。7例均行术中TEE检查,术后3个月2DE复查,主动脉反流束宽明显减轻(0.64±0.25)cm vs (0.22±0.04)cm,(P<0.01)、左心室舒张末期内径明显减小(5.69±0.45)cm vs (4.50±0.83)cm,(P<0.01)。结论2DE、3DE术前可以显示主动脉瓣的数目、大小、狭窄及反流的程度,比较准确地诊断主动脉瓣病变,但容易漏诊合并的冠状动脉畸形;TEE在术中即刻效果判断、2DE在术后随访中起重要作用,是儿童主动脉瓣病变Ozaki手术安全、有效的监测方法。
