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心室壁瘤的外科治疗:切除术后血流动力学变化分析(作者译)

[Surgical treatment of ventricular aneurysm: an analysis of post-resection haemodynamic changes (author's transl)].

作者信息

Schäfer G E, Kober G, Becker H J, Guldner N, Kaltenbach M

出版信息

Dtsch Med Wochenschr. 1976 May 7;101(19):734-8. doi: 10.1055/s-0028-1104170.

Abstract

Of 500 patients with angiographically proven myocardial infarction 75 had a left ventricular aneurysm. 25 of them subsequently had resection of the aneurysm. Postoperative studies revealed marked improvement of symptoms. Pulmonary arterial pressure was significantly decreased at rest (from 28 to 20 mm Hg) and on exercise (from 58 to 35 mm Hg). There was a reduction in left ventricular end-diastolic volume (from 247 to 1.54 ml/1.73 m2) and a raised ejection fraction (from 36 to 59%). Good results were obtained especially in those patients who had congestive heart failure due to paradoxical systolic expansion of the ventricular wall and (or) secondary reversible damage in the remaining viable myocardium. Left ventricular aneurysms should be suspected after myocardial infarction when there is left ventricular failure and an increase in heart size.

摘要

在500例经血管造影证实为心肌梗死的患者中,75例有左心室室壁瘤。其中25例随后接受了室壁瘤切除术。术后研究显示症状有明显改善。静息时肺动脉压显著降低(从28毫米汞柱降至20毫米汞柱),运动时也降低(从58毫米汞柱降至35毫米汞柱)。左心室舒张末期容积减少(从247毫升/1.73平方米降至154毫升/1.73平方米),射血分数提高(从36%升至59%)。尤其在那些因心室壁矛盾性收缩扩张和(或)剩余存活心肌继发性可逆性损害而出现充血性心力衰竭的患者中取得了良好效果。当心肌梗死后出现左心室衰竭且心脏增大时,应怀疑有左心室室壁瘤。

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