心肌梗死后心脏破裂：外科治疗
Post-infarction cardiac rupture: surgical treatment.
作者信息
Mantovani Vittorio, Vanoli Davide, Chelazzi Paolo, Lepore Vincenzo, Ferrarese Sandro, Sala Andrea
机构信息
Department of Cardiac Surgery, Ospedale di Circolo-Fondazione Macchi, Università dell'Insubria, Viale Borri 57, 21100 Varese, Italy.
出版信息
Eur J Cardiothorac Surg. 2002 Nov;22(5):777-80. doi: 10.1016/s1010-7940(02)00485-2.
OBJECTIVE
Rupture of ventricular free wall (VFWR) may complicate acute myocardial infarction and accounts for high mortality. Surgical repair is the only therapeutic option. A review of our surgical experience is presented.
METHODS
Seventeen patients (11 men, mean age 68 years) underwent surgery for VFWR. Patch covering technique was used in 13 patients, infarctectomy with patch reconstruction in three patients, direct suture without patch in one patient. Coronary artery bypass grafting was performed in eleven patients.
RESULTS
Hospital mortality was 17.6% (three patients). Three patients died of cancer during the follow-up. The remaining 11 patients are in good condition after a mean follow-up of 45.8 months (range 7.5-84.2).
CONCLUSIONS
Postinfarction rupture of ventricular free wall treated surgically gives excellent long-term results. Our first choice for repair is the covering technique with a large pericardial patch anchored with biological glue and epicardial sutures.
目的
心室游离壁破裂（VFWR）可能使急性心肌梗死复杂化，且死亡率很高。手术修复是唯一的治疗选择。本文介绍了我们的手术经验。
方法
17例患者（11例男性，平均年龄68岁）接受了心室游离壁破裂修复手术。13例患者采用补片覆盖技术，3例患者采用梗死灶切除术加补片重建，1例患者采用无补片直接缝合。11例患者进行了冠状动脉旁路移植术。
结果
医院死亡率为17.6%（3例患者）。3例患者在随访期间死于癌症。其余11例患者平均随访45.8个月（范围7.5 - 84.2个月）后情况良好。
结论
手术治疗心肌梗死后心室游离壁破裂可取得优异的长期效果。我们首选的修复方法是使用生物胶和心外膜缝线固定的大的心包补片覆盖技术。
Zotero 插件