[双室右心室,在成年时难以进行心室隔膜缺陷的术前诊断]
Iroha Yamamoto1, Masahiro Kaneko, Norihiko Oka
1Department of Pediatric and Congenital Cardiovascular Surgery, Jichi Children's Medical Center Tochigi, Shimotsuke, Japan.
Kyobu geka. The Japanese journal of thoracic surgery
|October 6, 2024
概括
在患有先天性心脏病的成年人中,心声扫描可能会错过腹腔隔膜缺陷 (VSD),导致在手术期间发现的意想不到的转移. 结合成像方法可以提高VSD诊断的准确性.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 患有先天性心脏病 (CHD) 的成年人可能会出现复杂的疾病,如右心室外流管狭窄和双室右心室.
- 手术前的诊断成像,特别是心声回声,可能并不总是揭示所有的心内异常,如心室隔膜缺陷 (VSDs).
- 某些心脏结构的动态性质,如隔膜动脉瘤,可以掩盖VSD,导致手术前和手术内发现之间的差异.
研究的目的:
- 为了突出诊断腹腔隔膜缺陷 (VSDs) 的潜在差异,在患有特定先天性心脏病的成年患者.
- 强调在与右心室外流管狭窄或双室右心室等条件相关时,在手术前检测VSD的挑战.
- 为了强调考虑结合成像模式的重要性,以准确诊断成年人的心脏病.
主要方法:
- 分析了两名患有症状性先天性心脏病的成年女性患者的病例报告.
- 使用了手术前心声学和手术内食管横心声学.
- 对已识别的VSD进行手术发现和干预进行了记录.
主要成果:
- 在案例1中,在初始心声扫描显示没有分线后,在手术期间意外发现了一种VSD,需要进行手术关闭.
- 在案例2中,外膜性VSD被隔膜动脉瘤掩盖在术前心电回声学上,并没有在术后检测到任何分离器.
- 这些案例说明了VSD的心声回声检测结果在复杂心脏病的成年人中在手术前和手术后的评估之间如何有显著差异.
结论:
- 术前心声学可能无法检测VSD在成年人与右心室外流通道狭窄或双室右心室.
- 在手术期间的发现可以揭示在初始成像中不明显的意想不到的突变.
- 整合多种成像方法对于提高成人先天性心脏病的诊断准确性至关重要.
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