[Diagnosis of right ventricular outflow tract and intraoperative lesion in patients with right coronary artery sinus rupture by transthoracic echocardiography].

OBJECTIVE: To investigate the role of thoracic echocardiography in diagnosis and differential diagnosis of the right ventricular outflow tract into the right aorta with right ventricular aneurysm rupture. 
 Methods: A total of 19 patients with sinus rupture caused by ventricular septal defect in the right ventricular outflow road were reviewed. These patients were diagnosed as aortic right coronary sinus by preoperative transthoracic echocardiography from February 2010 to September 2016 in Xiangya Second Hospital and Xiangya Medical College Affiliated Haikou Hospital. The clinical symptoms, echocardiography and intraoperative lesions were compared and analyzed among the patients.
 Results: The intraoperative lesions were consistent with the preoperative echocardiographic diagnosis in 16 patients. Among them, 11 cases could be heard the continuous sound of the machine with systolic murmur and no tremor in left sternal rib 2-3 auscultation. The color Doppler imaging of right ventricular systolic indicated the based continuous Doppler spectrum. The preoperative echocardiography and intraoperative lesions testified the ventricular septal defect size and the right ventricular outflow tract into the right aorta with right ventricular aneurysm rupture. Among them, 3 cases were complicated with other heart diseases. Other 3 cases were not accorded with the preoperative diagnosis. There were auscultation smell and noise but no tremor. The preoperative echocardiography and lesions indicated the right ruptured aneurysm of the sinus of big and long mouth, 1 case with aortic valve stenosis and regurgitation, congenital aortic valve two valve malformation, 1 case with aortic valve-severe reflux, 1 case with pulmonary infection, and 3 cases with no intraoperative lesions in the ventricular septal defect.
 Conclusion: Preoperative transthoracic echocardiography is the preferred preoperative, quick and noninvasive method for ruptured aneurysm. Each stage of observation procedure and method can observe the ruptured aneurysm of aortic sinus, the location, size and adjacent of ventricular septal defect. Meanwhile, the flow spectrum characteristics of the ventricular septal defect in the right outflow tract of the right sinus aneurysm can be found by Doppler ultrasound imaging.