目的探讨婴儿左冠状动脉异常起源于肺动脉(anomalous origin of left coronary artery from pulmonary artery,ALCAPA)的临床特点、诊断及治疗方法。方法回顾性分析13例行手术治疗的ALCAPA患儿临床资料。结果 13例患儿均有不同程度心功能不全,经心脏超声及CT造影检查明确诊断,合并二尖瓣反流轻度5例,中度4例,重度4例;冠状动脉直接移植至升主动脉8例,延长左冠状动脉开口后移植于主动脉5例;同期行二尖瓣成形4例;体外循环时间(121.8±53.2)min,主动脉阻断时间(79.4±37.5)min,呼吸机辅助时间15.5~55.5h,ICU时间35.0~160.5h,术后左室射血分数(45.4±15.5)%;住院期间因低心排出量综合征死亡1例,另12例随访1~109个月,患儿左室射血分数为(63.2±12.1)%,二尖瓣反流轻度10例,中度2例,无需再次手术者。结论婴儿ALCAPA临床表现无特异性,早期诊断并及时行冠状动脉移植手术有助于心功能改善,合并二尖瓣重度反流者同期行二尖瓣成形手术效果良好。
【英文摘要】
Objective To investigate the clinical characteristics,diagnosis and surgical treatment of anomalous origin of left coronary artery from pulmonary artery(ALCAPA)in infants.Methods The clinical data of 13 infants with ALCAPA undergoing surgery were retrospectively analyzed.Results All patients had cardiac dysfunction in different degrees and were confirmed by echocardiography and CT.The complications included mild mitral regurgitation in 5patients,moderate mitral regurgitation in 4and severe mitral regurgitat...
【基金】
河南省教育厅科学技术研究重点项目(14B320029)
【更新日期】
2017-09-18
【分类号】
R726.5
【正文快照】
左冠状动脉异常起源于肺动脉(anomalous originof left coronary artery from pulmonary artery,ALCAPA)是一种少见的先天性心脏病,发病率约为1/30万[1]。由于左冠状动脉灌注压低,左、右冠状动脉侧枝较少、且左冠状动脉为缺氧的静脉血,疾病早期患儿即出现心脏扩大、心内膜增厚?