胎儿二叶式主动脉瓣畸形的超声心动图特征分析  

Echocardiographic features of fetal bicuspid aortic valve

作　　者：郑敏 刘晓伟[1] 孙琳[1] 刘文旭[1] 谷孝艳[1] 张烨[1] 薛超[1] 何怡华[1] ZHENG Min;LIU Xiaowei;SUN Lin;LIU Wenxu;GU Xiaoyan;ZHANG Ye;XUE Chao;HE Yihua(Echocardiography Medical Center,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,Chinaa)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所、心脏超声医学中心、北京安贞医院胎儿心脏病母胎医学中心,100029

出　　处：《心肺血管病杂志》2023年第3期262-265,273,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研究计划(U21A20523)。

摘　　要：目的:探讨确诊二叶式主动脉瓣(BAV)畸形的胎儿超声心动图特征及预后。方法:对生后确诊BAV的患者产前超声心动图进行回顾和分析,并对其特征进行总结。结果:14例生后确诊患者产前胎儿超声心动图均有异常超声征象提示,包括直接征象(主动脉瓣增厚、回声增强、融合嵴、两个交界及“鱼嘴样开口”、活动及开放受限、一字型关闭线或偏心关闭线)及间接征象(主动脉瓣上流速增快,升主动脉增宽)。其中2例患者产前均进行了3次胎儿超声心动图检查,发现主动脉瓣上流速及升主动脉内径随着孕周的增大而增加。14例患者中,2例(14.3%)出生后因主动脉瓣中重度狭窄出现生长发育受限,其中1例于2个月龄进行主动脉瓣球囊扩张治疗。结论:胎儿BAV主要依靠产前超声心动图筛查,直接超声征象结合间接超声征象可帮助诊断。超声医师疑诊胎儿BAV应建议其父母规律随访患儿主动脉瓣及主动脉情况,有助于确诊及预后咨询。Objective:To investigate the fetal echocardiographic characteristics of fetuses with confirmed bicuspid aortic valve(BAV).Methods:The prenatal echocardiograms of patients with a postnatal diagnosis of BAV were reviewed and analyzed,and their characteristics were summarized.Results:Abnormal fetal echocardiographic signs had been observed in the 14 patients with a postnatal diagnosis of BAV,including direct signs(aortic valve thickening,high echogenic,raphe,opening in two lobes,restriction of activity and opening,and one-line or eccentric closure lines)and indirect signs(increased flow velocity over the aortic valve and widening of the ascending aorta).In 2 of these patients,3 times of fetal echocardiograms had been performed prenatally.And the supra-aortic valve flow velocity and the diameter of the ascending aorta increased with increasing gestational weeks.2(14.3%)patients had growth restriction after birth because of moderate to severe aortic stenosis and one of them underwent aortic valve balloon dilation at 2 months of age.

关 键 词：先天性心脏病 二叶式主动脉瓣 胎儿 产前诊断 超声心动图 

分 类 号：R54[医药卫生—心血管疾病]