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Distal type of aortopulmonary window. Report of 4 cases.

机译:肺门窗远端类型。报告4例。

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摘要

We have studied 14 patients with aortopulmonary window (10 male and 4 female, age range 1 month to 41 years). Four of these had a distal defect with characteristic haemodynamic and angiographic features. Aortopulmonary window may be classified into 3 types: type I (proximal) defects occur in the proximal part of aortopulmonary septum; type II (distal) defects occur in the distal part of the aortopulmonary septum adjacent to the right pulmonary artery; the type III defect is a combination of types I and II. In type I, injection of contrast media into the aortic root opacifies the main pulmonary trunk and then both pulmonary arteries. In type II, the right pulmonary artery is preferentially opacified simulating the finding of right pulmonary artery arising from the ascending aorta. In one case of type II, injection into the right ventricle showed preferential flow to the left pulmonary artery, because of the large shunt of unopacified blood into the right pulmonary artery, but in both types I and II the left and right pulmonary arteries are usually opacified simultaneously after injection into the main pulmonary trunk. In type I either transaortic or transpulmonary closure is the appropriate surgical procedure. In types II and III, the transaortic approach provides better exposure and facilitates the operative repair.
机译:我们研究了14例主肺窗患者(男10例,女4例,年龄1个月至41岁)。其中四个具有远端缺损,具有特征性的血流动力学和血管造影特征。主肺窗可分为3种类型:I型(近端)缺损发生在主肺隔的近端部分。 II型(远端)缺陷发生在与右肺动脉相邻的主肺隔的远端; III型缺陷是I型和II型的组合。在I型中,将造影剂注入主动脉根使主肺干和随后的两个肺动脉不透明。在II型中,模拟发现由升主动脉引起的右肺动脉时,右肺动脉优先不透明。在一种II型病例中,由于未混浊的大量血液流入右肺动脉,因此向右心室注射显示优先流向左肺动脉,但在I型和II型中,通常左,右肺动脉通常注入主肺干后同时混浊。在I型中,经主动脉或经肺关闭是合适的手术方法。在II型和III型中,经主动脉途径可提供更好的暴露并促进手术修复。

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