The Comparative Study Between The Pulmonary Pathological Changes And The Diagnostic Imaging In Complex Congenital Heart Defect With Diminished Pulmonary Flow In Infant

Part One The classification of pulmonary blood supply in complex congenital heart defectwith diminished pulmonary blood flow in infant Objective:To analysis pulmonary blood supply in complex congenital heart defect with diminished pulmonary blood flow in infant.Methods:From January 1985 to December 2000, there were 96 cases with complex congenital heart defect with diminished pulmonary blood flow, aged 4—36 (22.24± 9.36)months. 65 cases were male, 31 cases were female. There were 41 cases of TOF, 22 cases of PA-VSD, 3 cases of PA-IVS, 10 cases of DORV, 11 cases of SV, 4 cases of TA, 2 cases of TECD, 2 cases of TGA and 1 case of ccTGA.The classification standard was the pulmonary blood supply. Type A, pulmonary arterial blood flow was only from right ventricle; Type B, the pulmonary blood flow was from PDA and/or aortopulmonary collateral arteries. Type C, the lung accepted both pulmonary arterial blood flow and systemic arterial blood flow.Results:There were three sorts according to pulmonary blood supply. First, the pulmonary blood supply was only from right ventricle in 56 cases that means there was 58.33% in all cases(56/96), aged 4—36 (20.98±9.91) months. They were 34 cases of TOF, 7 cases of DORV, 9 cases of SV, 4 cases of TA and 2 cases of TECD.Second, the pulmonary blood supply was from PDA and/or aortopulmonary collateral arteries in 25 cases that means there was 26.04% in all cases (25/96), aged 4~36 (20.20±12.04) months. The main diagnosis was PA, which was including 3cases of PA-IVS, 22 cases of PA-VSD. All cases had confluent of central pulmonary artery. Both PDA (21 cases) and aortopulmonary collateral arteries (3 cases) were distributed to such arteries which anastomosised with central pulmonary artery at the hilum of the lung. Aortopulmonary collateral arteries of one patient directedly went into right upper lung, right lower lung and left upper lung. PDA and aortopulmonary collateral artery were concomitant in one patient, there was no stricture between aortopulmonary collateral artery and pulmonary artery and the diameter of the aortopulmonary collateral artery was 6mm.