主动脉瓣下隔膜的临床观察  

Clinical observation of subaortic membrane

作　　者：李晓锋[1] 朱耀斌[1] 刘爱军[1] 曹跃丰[1] 苏俊武[1] 李玲[1] 范祥明[1] 李志强[1] 刘迎龙[1] 

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏中心,北京100029

出　　处：《中华实用诊断与治疗杂志》2014年第6期576-577,580,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：北京市科技计划项目(Z111100074911001);北京安贞医院种子基金(2002Z02)

摘　　要：目的分析主动脉瓣下隔膜临床特点。方法回顾性分析32例主动脉瓣下隔膜患者术前超声及术中探查结果,分析隔膜位置、范围、合并畸形及主动脉瓣情况等。结果 31例术前经胸超声检查确诊主动脉瓣下隔膜,1例术前检查漏诊术中证实为主动脉瓣下隔膜;主动脉瓣下隔膜位于室间隔缺损下缘3例,无冠瓣下3例,右冠瓣与无冠瓣交界下3例,右冠瓣下6例,左右冠瓣交界下12例,环形隔膜5例;单纯主动脉瓣下隔膜7例,合并室间隔缺损21例(干下型室间隔缺损3例,膜周型室间隔缺损18例),合并二尖瓣关闭不全、动脉导管未闭各1例,动脉导管封堵术后及主动脉缩窄矫治术后再发主动脉瓣下隔膜各1例;18例合并不同程度主动脉瓣关闭不全。结论主动脉瓣下隔膜以左右冠瓣交界下及右冠瓣下方多见,可引起主动脉瓣关闭不全及主动脉瓣增厚,应尽早矫治。Objective To analyze the clinical characteristics of subaortie membrane. Methods Thirty-two patients with subaortic membrane were analyzed the results of preoperative echocardiographic findings and operation results to summarize the position, range, abnormalties complicated and subaortic valve. Results Thirty-one patients with subaortic membrane were confirmed by transthoracic eehocardiography preoperatively, and one patient with preoperative missed diagnosed was confirmed subaortie membrane during operation. The subaortic membrane was located in inferior of the ventrieular septal defect （VSD） in 3 patients, beneath the noneoronary artery cusp in 3, beneath the commissure of right coronary artery cusp and noncoronary artery cusp in 3, under the right coronary artery cusp in 6, beneath the commissure of left-right cusp in 12, and in the ring membrane in 5. Simple membrane without other cardiac lesion were found in 7 patients. Subaortic membrane complicated with VSD were found in 21 patients （subarterial VSD in 3 and membranous VSD in 18）. One patient was complicated with patent ductus arteriosus and one was complicated with mitral insufficiency. Subaortic membrane developed after patent ductus arteriosus occlusion in one patient and after correction of aortic eoarctation in one patient. Eighteen patients were complicated with aortic valve insufficiency. Conclusions The subaortic membrane is commonly located beneath the right coronary cusp and the commissure of left-right cusp, which can lead to severe problems such as aortic insufficiency. Therefore, the patients should be performed early surgical correction.

关 键 词：先天性心脏病 主动脉瓣下隔膜 室间隔缺损 

分 类 号：R726.5[医药卫生—儿科]