产前诊断双主动脉弓并结局随访10例报道  

Prenatal diagnosis and outcomes in fetal double aortic arch:an analysis of 10 cases

作　　者：谭玉玉 庞程程[1] 申俊君[1] 蒋秋平 李江林[1] 温树生[1] 庄建[1] 孙云霞[1] 潘微[1] TAN Yu-yu;PANG Cheng-cheng;SHEN Jun-jun;JIANG Qiu-ping;LI Jiang-lin;WEN Shu-sheng;ZHUANG Jian;SUN Yun-xia;PAN Wei(Department of Maternal-Fetal Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所心脏母胎科,广东省人民医院(广东省医学科学院),广州510080

出　　处：《岭南心血管病杂志》2020年第3期309-312,364,共5页South China Journal of Cardiovascular Diseases

基　　金：国家重点研发计划资助(项目编号:2018YFC1002602)。

摘　　要：目的探讨胎儿双主动脉弓(double aortic arch,DAA)产前诊断及生后结局随访。方法收集广东省人民医院心脏母胎科2016年8月至2019年8月经胎儿超声心动图诊断并生后确诊为DAA的10例胎儿的超声心动图及生后结局随访资料。结果10例胎儿诊断时孕周22~33周;超声心动图在三血管-气管切面、左心室长轴切面显示升主动脉发出左侧及右侧主动脉弓,形成“O”形血管环,包绕气管和食管。10例经产前咨询后足月出生,其中右弓优势型9例,均衡型1例。1例患儿生后出现气促、喘鸣等临床症状,心脏计算机断层扫描(CT)及纤维支气管镜提示气管受压明显。其余9例无明显临床症状,其中4例行纤维支气管镜检查,3例存在轻度气管狭窄。共3例行手术治疗,术后恢复良好。结论DAA可产前明确诊断,并进一步分型,通过心血管专业产前咨询,制定临床治疗策略。生后有症状患儿需尽早手术,效果良好。无气道、食道压迫症状患儿可长期随访。Objectives To explore the prenatal diagnosis and postnatal outcome in fetus with double aortic arch(DAA).Methods We retrospectively collected echocardiography and postnatal follow-up data of 10 fetuses diagnosed with DAA from August 2016 to August 2019 in Department of Maternal-Fetal Cardiology Guangdong Provincial People's Hospital.Results Ten fetuses were diagnosed at 22-33 week's gestation.Echocardiography showed that in 3-vessel and trachea view,the aorta gave rise to the right and left aortic arch demonstrated a O-shaped appearance of the great vessels.The trachea and esophagus were surrounded by this O-shaped vascular ring.Ten full term infants were born after antenatal consultation,among which,9 cases were right-arch dominant type and 1 case was balanced type.One infant had shortness of breath and wheezing after delivery,cardiac computed tomography(CT)and fiberoptic bronchoscopy showed significant pressure on the trachea.The remaining 9 patients were asymptomatic,4 of whom underwent fiberoptic bronchoscopy and 3 had mild tracheal stenosis.A total of 3 patients underwent surgery and recovered well after surgery.Conclusions DAA can be clearly diagnosed and further classified in prenatal echocardiography.For patients with compression symptoms,early surgery should be performed,and long-term prognosis is usually satisfied.In contrast,long-term follow-up can be performed without airway and esophageal compression symptoms.

关 键 词：双主动脉弓 产前诊断 血管环 

分 类 号：R541.1[医药卫生—心血管疾病]