Further observations on cerebral or retinal ischemia in patients with right-left intracardiac shunts.
Further observations on cerebral or retinal ischemia in patients with right-left intracardiac shunts.
复制标题
左右心内分流患者脑或视网膜缺血的进一步观察。
作者：
J. Biller;Maryl R. Johnson;Harold P. Adams;Richard E. Kerber;James J. Corbett;Askiel Bruno;Richard J. Leth
1983年10月至1986年11月，20名疑似脑部或视网膜栓塞症的患者被确诊。脑梗塞是最常见的临床表现。6例患者经心导管术或手术证实卵圆孔未闭。三名患者有新发现的房间隔缺陷，一名患者有之前手术治疗的房间隔缺陷。12例患者的心脏体格检查、胸部X线片和心电图检查结果均无显著差异。超声心动图显示18例患者存在右向左分流。其中9例患者接受了心导管术；7例患者有异常的导尿管检查结果：4例卵圆孔未闭，3例房间隔缺损。16名患者只接受了内科治疗，4名患者接受了手术。所有患者都在最初的侮辱中幸存下来。随访1个月至3年，无一例死亡或缺血复发。我们相信，声学造影可以提供重要的诊断信息，即使在不怀疑心脏受累的情况下也是如此。在确定推定的悖论脑栓塞的最佳治疗方案之前，还需要进一步的研究。
Between October 1983 and November 1986, 20 patients suspected of having a paradoxical cerebral or retinal embolism were identified. Cerebral infarction was the most common presentation. Six patients had a patent foramen ovale demonstrated by cardiac catheterization or surgery. Three patients had a newly discovered atrial septal defect, and one had an atrial septal defect that had previously been treated surgically. Results of the cardiac physical examination, chest roentgenography, and electrocardiography were unremarkable in 12 patients. Eighteen patients had a right-to-left shunt demonstrated by contrast echocardiography. Nine of these patients underwent cardiac catheterization; seven had abnormal catheterization study results: four had a patent foramen ovale and three had an atrial septal defect. Sixteen patients received medical therapy only while four underwent surgery. All patients survived the initial insult. There were no deaths or ischemic recurrences on follow-up ranging from one month to three years. We believe that contrast echocardiography can provide important diagnostic information, even in situations in which cardiac involvement is not suspected. Additional studies are needed before the optimal treatment of presumptive paradoxical cerebral embolism can be determined.
影响因子：
39.2
作者：
Lovett,JL;Sandok,BA;Giuliani,ER;Nasser,FN
通讯作者：
Nasser,FN