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首页> 外文期刊>Circulation journal >Prediction of Therapeutic Strategy and Outcome for Antenatally Diagnosed Pulmonary Atresia/Stenosis With Intact Ventricular Septum
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Prediction of Therapeutic Strategy and Outcome for Antenatally Diagnosed Pulmonary Atresia/Stenosis With Intact Ventricular Septum

机译：完整室间隔的产前诊断肺动脉闭锁/狭窄的治疗策略和结果预测。

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Background The therapeutic strategy for pulmonary atresia (PA) and severe pulmonary stenosis (PS) with intact ventricular septum is controversial. Recent improvements in prenatal detection necessitate the identification of predictors of outcome for appropriate counseling and prenatal management planning.Methods and Results Echocardiograms of 18 fetuses antenatally diagnosed with PA (n=14) and PS (n=4) were reviewed and the total cardiac dimension (TCD) and tricuspid valve diameter (TVD) were measured. The right ventricular end-diastolic volume (RVEDV) was calculated from the right ventriculogram of the neonatal period by the percentage of the predicted normal value (%RVEDV). There was a positive correlation between TVD/TCD and %RVEDV (p<0.001). As the initial treatment, balloon atrioseptostomy was performed in 13 cases of TVD/TCD <0.26. As the final treatment, patients with TVD/TCD <0.17 underwent or were planned for the Fontan procedure. Patients with TVD/TCD >0.21 underwent or were planned for biventricular repair. Patients whose TVD/TCD was between 0.17and 0.21 underwent or were planned for 1.5 ventricular repairs. Conclusion TVD/TCD is a useful index for selecting the postnatal initial treatment for PA/PS and to predict the final status of the fetus. Prenatal detection and prediction of the future status is helpful for family counseling. Furthermore, it will help to decide the postnatal management prenatally.
机译：背景技术对于具有完整心室间隔的肺动脉闭锁（PA）和严重肺动脉狭窄（PS）的治疗策略存在争议。方法和结果回顾分析了18例产前被诊断为PA（n = 14）和PS（n = 4）的胎儿的超声心动图，并对总的心脏尺寸进行了评估。 （TCD）和三尖瓣直径（TVD）被测量。根据新生儿期的右心室图，通过预测正常值的百分比（％RVEDV）计算右心室舒张末期容积（RVEDV）。 TVD / TCD与％RVEDV之间存在正相关（p <0.001）。作为初始治疗，在13例TVD / TCD <0.26的病例中进行了球囊造瘘术。作为最终治疗，TVD / TCD <0.17的患者已接受或计划接受Fontan手术。 TVD / TCD> 0.21的患者已接受或计划进行双室修复。 TVD / TCD在0.17至0.21之间的患者已接受或计划进行1.5次心室修复。结论TVD / TCD是选择PA / PS产后初始治疗并预测胎儿最终状态的有用指标。产前检测和对未来状况的预测有助于家庭咨询。此外，这将有助于在产前决定产后管理。

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