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目的分析主动脉瓣下隔膜临床特点。方法回顾性分析32例主动脉瓣下隔膜患者术前超声及术中探查结果,分析隔膜位置、范围、合并畸形及主动脉瓣情况等。结果 31例术前经胸超声检查确诊主动脉瓣下隔膜,1例术前检查漏诊术中证实为主动脉瓣下隔膜;主动脉瓣下隔膜位于室间隔缺损下缘3例,无冠瓣下3例,右冠瓣与无冠瓣交界下3例,右冠瓣下6例,左右冠瓣交界下12例,环形隔膜5例;单纯主动脉瓣下隔膜7例,合并室间隔缺损21例(干下型室间隔缺损3例,膜周型室间隔缺损18例),合并二尖瓣关闭不全、动脉导管未闭各1例,动脉导管封堵术后及主动脉缩窄矫治术后再发主动脉瓣下隔膜各1例;18例合并不同程度主动脉瓣关闭不全。结论主动脉瓣下隔膜以左右冠瓣交界下及右冠瓣下方多见,可引起主动脉瓣关闭不全及主动脉瓣增厚,应尽早矫治。
Objective To analyze the clinical characteristics of aortic valve. Methods A retrospective analysis of 32 cases of aortic valve under ultrasound before surgery and intraoperative exploration results, analysis of diaphragm location, scope, combined deformity and aortic valve situation. Results 31 cases of preoperative transthoracic ultrasonography confirmed aortic subvalvular membrane, 1 case of missed diagnosis of preoperative diagnosis of aortic valve septum; aortic valve diaphragm in the lower margin of ventricular septal defect in 3 cases, without crown flap 3 cases, 3 cases under the junction of the right coronary and non-coronary valve, 6 cases under the right coronary artery, 12 cases under the left and right coronary border, 5 cases with annular diaphragm, 7 cases with simple aortic subvalvular membrane and 21 cases with ventricular septal defect (3 cases of dry inferior ventricular septal defect and 18 cases of perimembranous ventricular septal defect) with mitral regurgitation, patent ductus arteriosus closed in 1 case, and patent ductus arteriosus closed and aortic stenosis treated Aortic valve under the diaphragm in 1 case; 18 cases with varying degrees of aortic regurgitation. Conclusion Under the aortic subvalvular membrane around the junction of the left and right coronary arteries and more common under the right coronary valve can cause aortic valve regurgitation and aortic valve thickening should be corrected as soon as possible.