Sharratt G P, Ross J K, Monro J L, Johnson A M
Br Heart J. 1976 Nov;38(11):1154-9. doi: 10.1136/hrt.38.11.1154.
Two cases of perforation of the left ventricle during mitral valve replacement are described. In the first case there was perforation at the site of papillary muscle excision and this was recognized and successfully treated. However, a true ventricular aneurysm developed at the repair site. One month after operation rupture of the left ventricle occurred at a second and separate site on the posterior aspect of the atrioventricular ring. This resulted in a false aneurysm which produced a pansystolic murmur mimicking mitral regurgitation. Both the true and the false aneurysm were successfully repaired. In the second case perforation occurred on the posterior aspect of the atrioventricular ring and was successfully repaired. However, a false ventricular aneurysm developed and ruptured into the left atrium producing severe, but silent, mitral regurgitation. This was recognized and successfully repaired. The implications of these cases are discussed.
本文描述了两例二尖瓣置换术中左心室穿孔的病例。第一例在乳头肌切除部位发生穿孔，该穿孔被识别并成功治疗。然而，修复部位形成了一个真性室壁瘤。术后一个月，左心室在房室环后方的第二个不同部位发生破裂。这导致了一个假性室壁瘤，产生了全收缩期杂音，类似于二尖瓣反流。真性和假性室壁瘤均成功修复。第二例在房室环后方发生穿孔并成功修复。然而，一个假性室壁瘤形成并破裂入左心房，导致严重但无症状的二尖瓣反流。该情况被识别并成功修复。文中讨论了这些病例的意义。
