The application value of echocardiography in evaluating total anomalous pulmonary venous connection combined with restricted and unrestricted atrial septal defect

Mo Ying; Ding Wenhong; Li Gang; Wang Xiaofang; Wang Qiang

doi:10.3760/j.issn.1673-4777.2024.02.006

Abstract：Objective To summarize the value of echocardiography in evaluating total anomalous pulmonary venous connection(TAPVC)combined with restricted and unrestricted atrial septal defect.Methods The echocardiography and clinical data of 49 patients with TAPVC admitted to Beijing Anzhen Hospital,Capital Medical University from January 2020 to June 2022 were retrospectively analyzed.Atrial septal defect ≤5 mm measured by echocardiography was set as the limit.Patients were divided into the restricted group(23 cases)and the unrestricted group(26 cases).Echocardiography was performed before surgery,1 and 3 months after surgery,respectively.Left ventricular diameter(LVD)and right ventricular diameter(RVD)and tricuspid valve regurgitation maximum pressure gradient(PTR)were measured.The changes of ventricular diameter and PTR before and after operation were analyzed and compared between the two groups.Results The preoperative echocardiographic diagnosis was consistent with the operative diagnosis in 49 cases,and the coincidence rate was 100％.Before surgery,LVD and LVD/RVD ratio in the restricted group were significantly lower than those in the unrestricted group,while PTR and RVD were significantly higher than those in the unrestricted group(all P＜0.01).There was no statistically significant difference in PTR,RVD,and LVD/RVD ratio between the two groups 1 and 3 months after surgery(all P＞0.05).The LVD of the restricted group was smaller than that of the unrestricted group 1 and 3 months after surgery[(19.3±4.2)mm vs(22.3±4.6)mm,(22.6±3.8)mm vs(25.9±3.7)mm](both P＜0.05).Conclusions Echocardiography is the first choice and accurate method for the diagnosis of TAPVC.Early diagnosis is beneficial to early surgical treatment,and can effectively evaluate the change of cardiac volume and the decrease of pulmonary hypertension,which has high clinical application value.