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心肌梗死后左心室假性动脉瘤

Left ventricular pseudoaneurysm after myocardial infarction.

作者信息

Koçak Hikmet, Becit Necip, Ceviz Münacettin, Unlü Yahya

机构信息

Department of Cardiovascular Surgery, Atatürk University, Medical Faculty, loj. No: 50/8, 25240 Erzurum, Turkey.

出版信息

Heart Vessels. 2003 Jul;18(3):160-2. doi: 10.1007/s00380-003-0693-0.

Abstract

In this report, a case of a left ventricular (LV) pseudoaneurysm due to a previous myocardial infarction, which was repaired successfully, is described. A 62-year-old man, with a history of acute anterior wall myocardial infarction 6 months previously, was admitted with the complaints of acute dyspnea and palpitation. Echocardiography revealed an LV aneurysm, and ventriculography showed ventricular dysfunction and an LV pseudoaneurysm. Coronary angiography showed total occlusion of the proximal segment of the left anterior descending artery with a very thin lumen and insufficient retrograde filling. Under cardiopulmonary bypass and beating heart, the pseudoaneurysm was resected and the defect on the ventricular free wall was closed by the remodeling ventriculoplasty method of Dor. Histopathologic examination of the resected material confirmed the diagnosis of pseudoaneurysm. The postoperative course of our patient was uneventful. He was discharged on the ninth postoperative day.

摘要

在本报告中,描述了一例因既往心肌梗死导致的左心室假性动脉瘤成功修复的病例。一名62岁男性,6个月前有急性前壁心肌梗死病史,因急性呼吸困难和心悸入院。超声心动图显示左心室动脉瘤,心室造影显示心室功能障碍和左心室假性动脉瘤。冠状动脉造影显示左前降支近端完全闭塞,管腔极细,逆行充盈不足。在体外循环和心脏跳动下,切除假性动脉瘤,采用Dor心室重建成形术方法封闭心室游离壁缺损。切除标本的组织病理学检查证实了假性动脉瘤的诊断。我们的患者术后过程顺利。术后第9天出院。

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