右心室减压和左心室功能在肺缩与完整的心室隔膜. 较不广泛的冠状动脉异常的影响
T L Gentles1, S D Colan, T M Giglia
1Department of Cardiology, Children's Hospital, Boston, MA 02115.
Circulation
|November 1, 1993
概括
右心室减压可以导致肺动脉缩和冠状动脉异常患者的左心室区域功能障碍. 这种功能障碍在减压前很常见,并在减压后增加,但严重的全局功能障碍很少见.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 心脏外科手术 心脏外科手术
背景情况:
- 在完整的心室隔膜下肺缩的右心室减压 (RVD) 可以导致心肌缺血症.
- 以前的研究表明,多重冠状动脉阻塞的死亡率很高.
- 在RVD后,较不严重的冠状动脉异常对左心室 (LV) 功能的影响尚不清楚.
研究的目的:
- 为了评估RVD对LV功能的影响,在患有较小范围冠状动脉异常的患者中.
- 评估该队列中RVD后区域和全球LV功能障碍的发生率和严重程度.
主要方法:
- 对12名冠状动脉异常 (囊和/或狭窄) 的患者进行了回顾性分析,他们接受了RVD.
- 术前和术后的2D心声回声学以评估全球和区域的LV功能.
- 在患有冠状动脉异常和没有冠状动脉异常的患者中对LV功能进行比较.
主要成果:
- 一名患有广泛冠状动脉干扰的婴儿死于RVD后严重的全球LV功能障碍.
- 无论冠状动脉异常,RVD之前和之后的平均LV喷射分数和终端透析体积保持相似.
- 区域性LV功能障碍在冠状动脉异常患者中更常见,在RVD后增加 (12%对照组<1%).
结论:
- 区域性LV功能障碍在患有较小范围冠状动脉异常的患者中很常见,并在RVD后增加.
- 严重的全球LV功能障碍是不寻常的,即使在较不广泛的冠状动脉异常.
- 冠状动脉异常是RVD后区域LV功能障碍发展的重要因素.
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