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目的探讨心血管造影在先天性心脏病(简称先心病)复杂和(或)复合畸形中的应用价值。方法分析360例复杂和(或)复合畸形造影所见及其与超声心动图等临床检查的联系。结果本组360例(包括75例肺动脉闭锁合并室间隔缺损、62例右室双出口、60例法乐四联症、52例单心室、42例大动脉错位、15例三尖闭锁、6例冠状动脉异常、5例完整型肺静脉畸形连接、5例完全型心内膜垫缺损、4例共同动脉干、3例室间完整的肺动脉闭锁、7例其他病例和24例外科术后检查)心血管造影和超声对比,纠正后者误、漏诊分别为34、30例及对合并畸形误诊16例。对复杂和(或)复合畸形中体肺侧支血管、冠状动脉畸形和肺动脉段分支及其异常的检测和诊断优于超声心动图,并可测量肺动、静脉压力及体肺侧支血管压力而优于其他影像学检查方法。结论对于先心病复杂和(或)复合畸形的疑难病例诊断和鉴别诊断,尤其显示体、肺及冠状动脉分支的全貌及相关病变,以及测量肺动脉和心室压力等,心血管造影(含DSA)仍有重要或不可替代的作用。
Objective To investigate the value of cardiovascular angiography in complicated and / or complex deformity of congenital heart disease (CHD). Methods Three hundred and sixty patients with complicated and / or complex deformity and their correlation with echocardiography and other clinical examinations were analyzed. Results The group of 360 patients (including 75 cases of pulmonary atresia with ventricular septal defect, 62 cases of right ventricular double outlet, 60 cases of Tetralogy of Fallot, 52 cases of single ventricle, 42 cases of major artery dislocation, 15 cases of tricuspid atresia, 6 cases of coronary 5 cases of complete pulmonary vein malformation connection, 5 cases of complete endocardial cushion defect, 4 cases of common artery trunk, 3 cases of complete pulmonary atresia in room, 7 cases of other cases and 24 cases of postoperative surgery) Cardiovascular Contrast contrast and ultrasound to correct the latter error, respectively, missed diagnosis of 34,30 cases and misdiagnosis of 16 cases. The detection and diagnosis of branch and abnormalities in the collateral vessels, coronary arteries, and pulmonary arteries in the complex and / or complex deformities are superior to echocardiography and can measure pulmonary arterial pressure and venous pressure and pulmonary vascular pressure And better than other imaging methods. Conclusions For the diagnosis and differential diagnosis of difficult cases with complicated and / or complex congenital heart disease, in particular the whole picture of the pulmonary and coronary artery branches and the related pathological changes, as well as the measurement of pulmonary artery and ventricular pressure, cardiovascular angiography (including DSA) There is an important or irreplaceable role.