超声心动图在共同动脉干术前诊断及术后随访中的临床价值

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ABSTRACTObjectiveTo explore the clinical value of echocardiography in the preoperative diagnosis and postoperative follw-upof truncus arteriosus communis（TAC）.MethodsAtotalof50children withTACclinicallydiagnosed andsurgically treated wereselected.Preoperativeand postoperativeechocardiographicdatawereanalyzed tosummarize the causesofmisdiagnosisandcomplicationsforidentifyingtheriskfactorsofreoperationinchildren.ResultsAll5Ochildren with TAC were confirmed by surgery，including 25 cases of van Pragh type A1，17 cases of type cases of type A3，and 4 cases of type A4.Preoperative echocardiography accurately diagnosed TAC in 49 cases （ 98.0% ），while 1 case of type A3 TAC was misdiagnosedaspulmonaryatresiawithanomalousoriginoftherightpulmonaryarteryfrom theascendingaorta. Echocardiography accurately classified the TAC type in 39 cases（ 78.0% ），including 23 cases of type A1，12 cases of type A2， 1 case of type A3，and 3 cases of type A4.Postoperative mortality occurrd in 11 cases（22.0%），with 39 cases（ 78.0% ） surviving. Postoperativecomplications includedconduitand pulmonaryartery branchstenosis（9cases），atrial level residual shunt （7cases），ventricularlevelresidualshunt（6cases），aortic valveregurgitation（4cases），andpulmonaryveinstenosis（3cases）. Survivingchildren wereregularlyfollowedupfor1-10 years，withamean follow-upperiodof（3.75±2.18）years.Amongthem， 27cases（ 69.23% ） underwentreoperation，including 17cases ofpulmonary artery conduit stenosis，7cases of pulmonaryarterybranch stenosis，2casesofmoderateaorticvalveregurgitation，andlcaseofleftpulmonaryveinstenosis.ConclusionEchocardiogaphy has significant clinical value in the preoperative diagnosis and postoperative follow-up of TAC. KEY WORDsEchocardiography;Truncus arteriosus communis ;Preoperative diagnosis; Postoperative follow-up

共同动脉干（truncusarteriosuscommunis，TAC）是指自心底仅发出1支大动脉，主动脉、肺动脉及冠状动脉均由该动脉发出的一种罕见的先天性心脏畸形，曾称为永存动脉干，约占先天性心脏病的 2%[1] 。（剩余7343字）