Aortopulmonary Window: Report of Two Cases

先天性心臓病大動脈－主肺動脈窗之二例

王作仁(Tso-Ren Wang) ； 呂鴻基(Hung-Chi Lue) ； 陳烱霖(Chi-Ren Hung) ； 洪啓仁(Chiung-Lin Chen)

《Acta Paediatrica Sinica》 14卷3期 (1973/09) Pp. 102-108

摘要

發現由左側至右側血流短路的先天性心臓病時，其鑑別診斷宜包含大動脈－主肺動脈窗，或即大動脈－主肺動脈中隔缺損。身體檢查，肺部X－光，甚至心電圖檢查都不能給我們確切的診斷。進一步的檢查要靠心臓導管術及心臓血管造影。這種先天性心臓病如未及時治療終必死亡，但如早期發現，在幼兒期即可施予外科手術而得痊癒。最近幾年，著者等於臺大小兒科，經由心臓導管術及心臓血管攝影發現兩例這種稀有的病例。這兩例在臺灣可說是此種先天性心臓病的首次報告。第一例是單純的大動脈－主肺動脈窗，經兩次心導管術的檢查，今年四月施行外科手術縫補，出院後情況一直很順利。第二例經心臓導管術檢查發現併有心室中隔缺損，著者等查及世界醫學文獻中僅有五例報告，該病例不久將接受外科矯正手術。

並列摘要

The differential diagnosis of the left to right shunts at the base of the heart must include aortopulmonary septal defect. Physical examination and clinical means such as chest X-ray films and electrocardiograms are helpful for the diagnosis but are usually giving only questionable results. Further diagnostic measures such as cardiac catheterization and angiocardiography are often necessary. The surgical correction even in a small infant can be successfully carried out. Two cases of the aortopulmonary septal defect, proved by cardiac catheterization, angiocardiography and/or surgery are reported. Case 1 is an isolated lesion and was successfully repaired at surgery. Case 2 is associated wit ii ventricular septal defect. Their physical findings, clinical course, cardiac catheterization data and angiocardiograms are presented. The diagnostic procedures and surgical managements are also discussed.