中国心血管杂志
中國心血管雜誌
중국심혈관잡지
Chinese Journal of Cardiovascular Medicine
2015年
5期
351-354
,共4页
金岩%王辉山%方敏华%于岩%王镇龙
金巖%王輝山%方敏華%于巖%王鎮龍
금암%왕휘산%방민화%우암%왕진룡
主动脉窦瘤破裂%室间隔缺损%解剖学特点
主動脈竇瘤破裂%室間隔缺損%解剖學特點
주동맥두류파렬%실간격결손%해부학특점
Rupture of sinus of Valsalva aneurysm%Heart septal defects,ventricular%Anatomy feature
目的:通过分析主动脉窦瘤破裂(RSVA)合并室间隔缺损(VSD)患者的临床资料,探讨其心脏解剖学特点,以提供术前精确诊断及术式良好预判。方法回顾性分析2003年9月至2014年4月我院经手术证实为 RSVA 患者80例,按是否合并 VSD 分为两组,比较两组患者心内畸形情况。结果80例患者分为 VSD 组38例(47.5%)和无 VSD 组42例(52.5%),VSD 组合并其他心内畸形的比例明显高于无 VSD 组[7例(18.4%)比1例(2.4%),P =0.043];无 VSD 组患者病史时间明显短于 VSD 组[(0.6±1.3)年比(5.9±11.3)年,P =0.002],且心功能 NYHA 分级明显差于 VSD 组(3.12±0.52比2.37±0.58,P =0.041)。 VSD 组合并主动脉瓣病变患者比例高于无 VSD 组[18例(47.4%)比3例(7.1%),P <0.001]。 VSD 组38例均起源于右冠窦,其中33例(86.8%)破入右心室流出道,而无 VSD 组42例起源部位绝大多数仍为右冠窦[38例(90.5%)],但破口部位较为分散。VSD 组与无 VSD 组的破裂部位构成比截然不同(χ2=55.98,P <0.001)。结论 RSVA 的部位与是否合并 VSD 可能存在明显相关性;合并 VSD 的 RSVA 患者更容易合并主动脉瓣病变。
目的:通過分析主動脈竇瘤破裂(RSVA)閤併室間隔缺損(VSD)患者的臨床資料,探討其心髒解剖學特點,以提供術前精確診斷及術式良好預判。方法迴顧性分析2003年9月至2014年4月我院經手術證實為 RSVA 患者80例,按是否閤併 VSD 分為兩組,比較兩組患者心內畸形情況。結果80例患者分為 VSD 組38例(47.5%)和無 VSD 組42例(52.5%),VSD 組閤併其他心內畸形的比例明顯高于無 VSD 組[7例(18.4%)比1例(2.4%),P =0.043];無 VSD 組患者病史時間明顯短于 VSD 組[(0.6±1.3)年比(5.9±11.3)年,P =0.002],且心功能 NYHA 分級明顯差于 VSD 組(3.12±0.52比2.37±0.58,P =0.041)。 VSD 組閤併主動脈瓣病變患者比例高于無 VSD 組[18例(47.4%)比3例(7.1%),P <0.001]。 VSD 組38例均起源于右冠竇,其中33例(86.8%)破入右心室流齣道,而無 VSD 組42例起源部位絕大多數仍為右冠竇[38例(90.5%)],但破口部位較為分散。VSD 組與無 VSD 組的破裂部位構成比截然不同(χ2=55.98,P <0.001)。結論 RSVA 的部位與是否閤併 VSD 可能存在明顯相關性;閤併 VSD 的 RSVA 患者更容易閤併主動脈瓣病變。
목적:통과분석주동맥두류파렬(RSVA)합병실간격결손(VSD)환자적림상자료,탐토기심장해부학특점,이제공술전정학진단급술식량호예판。방법회고성분석2003년9월지2014년4월아원경수술증실위 RSVA 환자80례,안시부합병 VSD 분위량조,비교량조환자심내기형정황。결과80례환자분위 VSD 조38례(47.5%)화무 VSD 조42례(52.5%),VSD 조합병기타심내기형적비례명현고우무 VSD 조[7례(18.4%)비1례(2.4%),P =0.043];무 VSD 조환자병사시간명현단우 VSD 조[(0.6±1.3)년비(5.9±11.3)년,P =0.002],차심공능 NYHA 분급명현차우 VSD 조(3.12±0.52비2.37±0.58,P =0.041)。 VSD 조합병주동맥판병변환자비례고우무 VSD 조[18례(47.4%)비3례(7.1%),P <0.001]。 VSD 조38례균기원우우관두,기중33례(86.8%)파입우심실류출도,이무 VSD 조42례기원부위절대다수잉위우관두[38례(90.5%)],단파구부위교위분산。VSD 조여무 VSD 조적파렬부위구성비절연불동(χ2=55.98,P <0.001)。결론 RSVA 적부위여시부합병 VSD 가능존재명현상관성;합병 VSD 적 RSVA 환자경용역합병주동맥판병변。
Objective About 50% of the rupture of sinus Valsalva aneurysm (RSVA) coexists with ventricular septal defect (VSD). The aim of this study was to provide accurate preoperative diagnosis and operation method anticipation by analyzing the clinical data of RSVA with / without VSD and exploring the heart anatomic features. Methods The clinical data of 80 patients with RSVA were retrospectively analyzed from September 2003 to April 2014. The patients were divided into two groups on the basis of the presence or absence of VSD. Results 80 patients were divided into 38 cases of VSD group (47. 5% ) and 42 cases of non-VSD group (52. 5% ). Patients in VSD group were more likely to suffer from other co-existing cardiac abnormalities than non-VSD group [7 (18. 4% ) Vs. . 1 (2. 4% ), P = 0. 043], and the duration of the symptoms shown by the patients of non-VSD group was significantly shorter than that of VSD group [(0. 6 ± 1. 3) years Vs. . ( 5. 9 ± 11. 3) years, P = 0. 002 ] . Patients' heart function in non-VSD group was significantly worse than that of the VSD group patients (3. 12 ± 0. 52 Vs. . 2. 37 ± 0. 58, P = 0. 041). 18 patients (47. 4% ) in VSD group and 3 patients (7. 1% ) in non-VSD group accompanied with aortic valve disease (P < 0. 001). In the VSD group, all the ruptured aneurysms of 38 patients originated in the right coronary sinus (RCS). In the non-VSD group, more than 90. 5% (38 / 42) of all the ruptured aneurysms also originated in RCS, but the ruptured positions in sinus of Valsalva aneurysm were dispersed. Through an analysis of the constituent ratio of the ruptured position in sinus of Valsalva aneurysm ( χ2 = 55. 98, P <0. 001), there was a significant difference between the two groups. Conclusions There is an obvious correlation between the RSVA site and with/ without VSD. The patients in VSD group are more likely to complicate with aortic valve disease than those in non-VSD group.