Analysis Of Echocardiography In 23 Cases Of Interrupted Aortic Arch

ObjectiveObserve the distribution of IAA classification and accompanied malformation,compare with studies of its kind at home and abroad,and summarize the morbidity characteristics and echocardiography characteristics of IAA and changes of IAA patients' left ventricular systolic function through analyzing conventional transthoracic echocardiography data and its characteristics of 23 cases of IAA patients.MethodRetrospective analysis of conventional transthoracic echocardiography data of 23 cases of IAA patients verified by the dual source CT examination in Yan'an Hospital Affiliated to Kunming Medical University from January 2009 to January 2018,including the diagnosis and classification of IAA,the accompanied malformation,hemodynamics,and left ventricular systolic function parameters.The main outcome measures of left ventricular systolic function parameters are shortening fraction(FS),ejection fraction(EF),end diastolic volume(EDV),end systolic volume(ESV)and stroke volume(SV).Classify each index of heart function according to the age and compare it with the normal reference range of the same-age group respectively.ResultsThere are totally 23 cases of patients,accounting for about 0.08%of the number of patients with congenital heart disease in the same period.There are 10 cases of Type A,accounting for about 43%,12 cases of Type B,accounting for about 52%,and 1 case of Type C,accounting for about 4%.Compared with the results of CTA,18 cases are diagnosed accurately by echocardiography,whose diagnostic coincidence rate is about 78%,among which there are 6 cases of Type A,with a diagnostic coincidence rate of about 60%,11 cases of Type B,with a diagnostic coincidence rate of about 92%,and 1 case of Type C,with a diagnostic coincidence rate of about 100%.Of all the cases,echocardiography fails to diagnose 2 cases of patients and only suggests that IAA is possible,accounting for about 8%in the whole group of patients and 3 cases of patients have not been explicitly classified,accounting for about 13%of the whole group of patients,among which 2 cases are diagnosed by CTA to be Type A,and 1 case is Type B.Among the 11 types of malformation of ventricular septal defect(VSD),patent ductus arteriosus(PDA),atrial septal defect(ASD),pulmonary stenosis(PS),aorticopulmonary septal defect(APSD),persistent truncus arteriosus(PTA),persistent left superior vena cava(PLSVC),aortic valve bicuspid deformity,subvalvular aortic stenosis and mitral stenosis(MS),the proportion of PDA is the largest,accounting for about 96%,and the interventricular septal defect is about 91%.Those with VSD and PDA accounting for 91%.The data of left cardiac function test shows that only 1 case of Type-C IAA patient's ventricular septum movement weakens,with the EF of about 54%.3 cases of patients have no abnormal cardiac function indexes.The indexes of rest 19 cases of patients,including FS,EF,EDV,ESV,SV all change compared with the normal reference range of the same age group.Among all the observation indexes,the change of EDV,ESV,SV is more obvious,accounting for over 70%of the whole group of patients,while FS and EF decrease.If we divide the cardiac function indexes into groups according to different classifications,The EDV,ESV and SV of Type A patients increase significantly,the EDV of Type B patients increases significantly and FS of Type B patients decreases significantly,and the EDV,ESV,SV of Type C patients increase while FS and EF of Type C patients decrease.As to the change of left cardiac function indexes between groups of different ages,the distribution of patients at the age of 1-6 is concentrated.ConclusionNoninvasive,simple and economical,the conventional transthoracic echocardiography can be used as the first choice for the diagnosis of IAA.It has irreplaceable advantage in the detection rate of cardiac malformation,hemodynamic analysis and cardiac function measurement,etc.However,there are some misdiagnoses and missed diagnoses.We should apply test methods like CT angiography(CTA)and magnetic resonance angiography(MRA)according to the condition of disease,which can effectively improve the accuracy of diagnosis.The study shows that influence of IAA and the hemodynamic disorder caused by its accompanied cardiac malformation is manifested in the significant change of left ventricular volume load,and EF declines to some extent,however,it has not reached the diagnostic criteria of echocardiography.The change of left cardiac function indexes is concentrated in patients at the age of 1-6.