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女性,6岁。发现心杂音3年,伴活动后心慌气短。查体:唇微绀,轻度杵状指(趾)。胸骨左缘第2、3肋间可闻及Ⅱ/6级 SM,P_2亢进、分裂。心电图示右心房室肥大。X 线平片示双肺血增多。心影呈“二尖辦”型。肺动脉段凸出,右心房、室增大。彩超示右房、室增大。左房见有一线状回声影。房间隔连续中断约2.4cm。临床以“三房心并房间隔缺损”而手术。术中于左心耳基底部可见直径约1cm的永存左上腔静脉,切开右心房,见巨大房间隔缺损(Ⅱ孔型),约3.5×4.5cm~2。仔细探查未见冠状静脉窦口。经房间隔缺损可见左房内有一纤维肌性隔膜,其右缘游离、左缘止于左心耳上缘。左上腔静脉及
Female, 6 years old. Heart murmur found 3 years, with palpitation after shortness of breath. Physical examination: lip cyanosis, mild clubbing (toe). Sternal 2,3 on the left edge of the intercostal can be heard and Ⅱ / 6 SM, P 2 hyperthyroidism, division. ECG right atrioventricular hypertrophy. X-ray showed double lung blood increased. Heart shadow was “two sharp” type. Pulmonary artery segment bulge, right atrium, ventricular enlargement. Choi ultrasound right room, room increased. Left atrium to see a linear echo shadow. Atrial septal discontinuity of about 2.4cm. Clinical “three heart and atrial septal defect” and surgery. Surgery in the left atrial appendage visible at a diameter of about 1cm of the left anterior superior left vena cava, incision of the right atrium, see a huge atrial septal defect (Ⅱ hole type), about 3.5 × 4.5cm ~ 2. Careful exploration of no coronary sinus ostium. Atrial septal defect can be seen within the left atrial muscle fibular diaphragm, the right edge of the free left edge of the left atrial appendage only. Left superior vena cava and