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頁籤選單縮合
| 題 名 | Application of Computed Tomography to Diagnose and Assess Patients with Dextro-Transposition of the Great Arteries (d-TGA) Complicated by Arrhythmia: A Case Report=應用電腦斷層診斷評估大動脈轉位症(d-TGA)合併心律不整病患:個案報告 |
|---|---|
| 作 者 | 李政翰; 林世杰; 連思婷; 許凱翔; 簡巧弦; | 書刊名 | 臺灣應用輻射與同位素雜誌 |
| 卷 期 | 21:1 2025.06[民114.06] |
| 頁 次 | 頁2349-2353 |
| 分類號 | 415.2165 |
| 關鍵詞 | 電腦斷層; 大動脈轉位症; 心律不整; Computed tomography; Dextro-transposition of the great arteries; Arrhythmia; |
| 語 文 | 英文(English) |
| 中文摘要 | 大動脈轉位症(d-TGA)是一種嚴重的先天性心臟畸形,特徵為主動脈和肺動脈的位置異常,導致體循環和肺循環的完全分隔。動脈切換術是矯正d-TGA的主要手術,但術後心律不整仍是一個值得關注的長期併發症。本個案報告為一位28歲男性,具有大動脈轉位症的手術史,因間歇性胸悶、呼吸困難、顫抖、頭暈及輕度水腫等症狀來診。初步心臟超音波和24小時心電圖檢查顯示有先天性心臟病和原發性肺動脈高壓症狀,並伴隨有心律不整。隨後進行了心臟消融術前評估,運用SIEMENS SOMATOM Force電腦斷層儀器來進行。影像結果顯示有肺動脈狹窄、右肺動脈狹窄、右心室肥大、右心房和右心室擴張以及三尖瓣環擴大。對於d-TGA術後的追蹤診斷,特別是合併心律不整狀況,需要跨單位團隊合作。初期多採用β受體阻滯劑和抗凝劑進行藥物治療,但對於持續且頻繁發生心律不整的情況,仍可能需要進行心臟消融術治療,以精確破壞導致心律不整的異常心電路徑,讓發作頻率顯著下降。本案例強調運用電腦斷層儀器在診斷可能導致心律不整的心臟結構異常方面的重要性,從而提供有效的臨床治療決策。 |
| 英文摘要 | Dextro-Transposition of the Great Arteries (d-TGA) is a severe congenital cardiac malformation characterized by the abnormal anatomical positioning of the aorta and pulmonary artery, resulting in the complete separation of the systemic and pulmonary circulations. The arterial switch operation is the primary surgical procedure to correct d-TGA; however, postoperative arrhythmias remain a significant long-term complication. This case report presents a 28-year-old male with a history of d-TGA surgery, who presented with intermittent symptoms of chest tightness, dyspnea, tremors, dizziness, and mild edema. Initial cardiac ultrasound and 24-hour Holter monitoring revealed congenital heart disease and primary pulmonary hypertension, along with arrhythmias. A pre-ablation assessment was subsequently conducted using the SIEMENS SOMATOM Force computed tomography (CT) scanner. The imaging results identified pulmonary valve stenosis, right pulmonary artery stenosis, right ventricular hypertrophy, dilation of the right atrium and right ventricle, and enlargement of the tricuspid annulus. Postoperative follow-up and diagnosis of patients with d-TGA and concomitant arrhythmias require a multidisciplinary approach. Initial treatment often involves the use of beta-blockers and anticoagulants. However, in cases of persistent and frequent arrhythmias, catheter ablation may be necessary to precisely destroy the abnormal electrical pathways causing the arrhythmia, thereby significantly reducing the frequency of episodes. This case underscores the importance of utilizing CT imaging in identifying structural abnormalities that may predispose to arrhythmogenesis, thus aiding in effective clinical decision-making for treatment strategies. |
本系統中英文摘要資訊取自各篇刊載內容。