The diagnostic value and postoperative follow-up analysis of echocardiography and CTA in children with aberrant subclavian artery
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The diagnostic value and postoperative follow-up analysis of echocardiography and CTA in children with aberrant subclavian artery
Journal of Clinical Ultrasound in MedicineVol. 25, Issue 2, (2023)
作者机构:
1. 上海交通大学医学院附属上海儿童医学中心
2. 华东师范大学
作者简介:
基金信息:
DOI:
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Published:2023,
Published Online:6 March 2023,
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The diagnostic value and postoperative follow-up analysis of echocardiography and CTA in children with aberrant subclavian artery. [J]. Journal of Clinical Ultrasound in Medicine 25(2).(2023)
DOI:
The diagnostic value and postoperative follow-up analysis of echocardiography and CTA in children with aberrant subclavian artery. [J]. Journal of Clinical Ultrasound in Medicine 25(2).(2023)DOI:
The diagnostic value and postoperative follow-up analysis of echocardiography and CTA in children with aberrant subclavian artery
Objective To analyze the preoperative diagnosis of aberrant subclavian artery (ASA) by echocardiography and CTA
and to evaluate the postoperative follow-up results. Methods Data of 192 childrens with ASA confirmed by cardiothoracic surgery were retrospectively analyzed. Results In 192 childrens
189 cases were right aortic arch with aberrant left subclavian artery (RAA-ALCA). 3 cases were left aortic arch with aberrant right subclavian artery (LAA-ARLA). 132 cases combine with other common cardiac structural malformations. The common malformations included 96 cases of Kommerell diverticulum
89 cases of atrial septal defect/patent foramen ovale
51 cases of ventricular septal defect
20 cases of left superior vena cava remaining
17 cases of patent ductus arteriosus. In 192 cases
echocardiography accurately diagnosed ASA in 124 cases (64.6%); 68 cases (35.4%) were misdiagnosed. A total of 174 cases (90.6%) were accurately diagnosed by CTA
and 18 cases (9.4%) were missed and misdiagnosed. In 132 cases complicated with other cardiac structural malformations
Echocardiography missed diagnosis of patent foramen ovale in 2 cases
47 cases of atrial septal defect/patent foramen ovale and small ventricular septal defect were missed by CTA diagnosis. In the follow-up of 96 children who underwent vagal left subclavian artery transplantation or Kommerell diverticulectomy
81 children who underwent vagal subclavian artery transplantation and Kommerell diverticulectomy had no obvious anastomotic obstruction
and 14 patients underwent CTA. Evaluated tracheal compression was less than preoperative.Conclusions Echocardiography and CTA in the preoperative diagnosis of ASA each have advantages and disadvantages
can respectively in the process of postoperative follow-up evaluation anastomotic and airway pressure situation
therefore
the joint multimodal inspections on echocardiography and CTA
can be more accurate diagnosis of ASA and merge heart abnormalities
as well as a more comprehensive evaluation of postoperative recovery effect.