四叶式主动脉瓣畸形的诊断及外科治疗  

Quadricuspid aortic valves： incidence, diagnosis and treatment

作　　者：孙晓宁[1] 赵强[1] 潘翠珍[2] 陈安清[1] 夏利民[1] 周光华[1] 王哲[1] 徐德民[1] 

机构地区：[1]复旦大学附属中山医院心脏外科,上海200032 [2]复旦大学附属中山医院心超室,上海200032

出　　处：《中华胸心血管外科杂志》2008年第3期166-168,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：本课题受上海市重点学科建设项目资助（B116）

摘　　要：目的总结四叶式主动脉瓣畸形的超声心动图诊断并探讨外科治疗。方法回顾分析上海市心血管病研究所2004年1月至2007年5月超声心动图资料，总结四叶式主动脉瓣膜病例的超声诊断特点。观察23例四叶式主动脉瓣四叶分布形态、回声、启闭及血流动力学情况。并总结分析手术治疗的9例病人的资料。结果在92656例心脏超声检查中，共检出四叶式主动脉瓣膜畸形23例，检出率为0．248‰。年龄19～83岁，平均（50．3±18．8）岁；男11例，女12例。23例中22例合并不同程度主动脉瓣膜反流，仅1例主动脉瓣膜功能正常。其中9例行主动脉瓣膜置换手术，术中发现A型8例，F型1例。结论四叶式主动脉瓣膜畸形是非常少见的先天性心脏畸形，多数由超声心动图检查发现，实时三维超声心动图对可疑病例可明确诊断。四叶式主动脉瓣膜畸形主要并发主动脉瓣膜反流，严重者应手术治疗。Objective Tostudytheincidenceand associated lesions of quadricuspid aortic valves （QAV） and to explore the echocardiographic diagnostic value and outcomes of surgical treatment. Methods Over a 3-year period, 92 656 patients were studied by rITE. Congenital quadricuspid aortic valve deformity was diagnosed by TIE and real time three-dimensional echocardiography. The morphologic changes, echoes, opening and closing of QAV and blood flow dynamics were observed by Philips SONOS-7500 color ultrasound system. Results Diagnosis of QAV was made in 23 patients （0. 248‰）. Their ages were 19 - 83 years, including 11 male, and 12 female. One patient showed normal QAV function, 5 had grade Ⅱ aortic regurgitation, 1 had gradeⅡ -Ⅲ aortic regurgitation,2 palient m, 10 patients Ⅲ - Ⅳ ,4 patients Ⅳ. 9 QAV patients underwent aortic valve replacement with surgical confirmation of the valve morphology. No stenosis was found. Associated lesions were mitral valve prolapse and tricuspid insufficiency. Conclusion QAV is rare, most of them may present with pure aortic regurgitation without stenesis. Severe aortic insufficiency requires surgical treatment.

关 键 词：主动脉瓣/畸形 超声心动描记术 心脏外科手术 

分 类 号：R686[医药卫生—骨科学]