右肺動脈源自升主動脈之超音波心圖診斷－病例報告

Identification of Anomalous Origin of Right Pulmonary Artery from Ascending Aorta by Echocardiography –A Case Report

寇崇德(Chang-Der Kow) ； 張嘉侃(Jia-Kan Chang) ； 陳豐霖(Feng-Lin Chern) ； 謝凱生(Kai-Sheng Hsieh)

《慈濟醫學雜誌》 8卷4期 (1996/12) Pp. 329-333

https://doi.org/10.6440/TZUCMJ.199612.0329

摘要

右肺動脈源自升主動脈是一極罕見的先天性心臟畸型。遲延診斷及治療常造成致命性的肺血管病變，若未及時接受手術常於一歲內死亡。本院報告一足月產嬰兒，於一個月大時因咳嗽、喘及心雜音而住入本院。入院後接受雙面超音波檢查由胸骨旁短軸切面(parasternal short axis view)無法偵側出正常肺動脈分岔(bifurcation)及正常右肺動脈型態和血流，由胸骨上切面(suprasternal view)胸骨旁長軸切面及劍突下切面(subcostal view)均可發現一不正常動脈由升主動脈之外側後方分出並流向右肺方向，之後病人並接受核磁共振造影、心導管及血管攝影檢查確定診斷，並於三個月大時接受手術，成功的將不正常源出血管和主肺動直接相接。由於此病例相當少見，特別提出報告討論。(慈濟醫學1996; 8:329-333)

關鍵字

肺動脈異常 ； 超音波心圖

並列摘要

Anomalous origin of one pulmonary artery from the ascending aorta is a rare congenital malformation. The natural history without surgery is poor with a very high mortality during the first year of life. Here, we reported a case of anomalous origin of the right pulmonary artery from ascending aorta in a one-month-old infant diagnose by the dimensional and color directed Doppler echocardiography. The anomalous vessel can be visualized arising from a posterolateral aspect of the ascending aorta be suprasternal and subcostal views. The absence of a bifurcation of the pulmonary trunk supports the identification of the anomalous vessel. Color Doppler examination aided in clearer delineation and consequent correct identification of the anomalous vessel as the right pulmonary artery. Surgical re-implantation of right pulmonary artery was carried out and successful. The diagnostic characteristics and therapeutic management of our case are discussed and literatures reviewed. (Tzu Chi Med J 1996; 8: 329-333)

並列關鍵字

anomalous pulmonary artery ； echocardiography