Donaldson R M, Honey M, Balcon R, Banium S O, Sturridge M F, Wright J E
Br Heart J. 1976 Dec;38(12):1223-8. doi: 10.1136/hrt.38.12.1223.
Thirty-two patients with large postinfarction left ventricular aneurysms shown at operation to consist of fibrous tissue are reported. All had angina and/or breathlessness, and none had a history of embolism. Thirty were correctly diagnosed by left ventricular cineangiography. Two of the 3 patients with inferior and 1 with an anterior aneurysm had associated ventricular septal defects, and 3 patients with an anterior aneurysm had mitral regurgitation. All had major coronary arterial lesions and 68 per cent had double or triple vessel disease. The aneurysm was excised in all patients; in 15 this was combined with saphenous vein bypass grafting of coronary arteries supplying surviving myocardium, in 3 with closure of a ventricular septal defect, and in 3 with mitral annuloplasty or replacement. Operative mortality was 6-2 per cent, and 79 per cent of the survivors are asymptomatic with average follow-up period of 18 months after operation.
报告了32例经手术证实为纤维组织构成的大面积心肌梗死后左心室室壁瘤患者。所有患者均有胸痛和/或气促症状，无一例有栓塞病史。30例经左心室心血管造影得到正确诊断。下壁室壁瘤患者中有3例、前壁室壁瘤患者中有1例合并室间隔缺损，前壁室壁瘤患者中有3例合并二尖瓣反流。所有患者均有严重冠状动脉病变，68%患者有双支或三支血管病变。所有患者均行室壁瘤切除术；15例同时行大隐静脉旁路移植术，以向存活心肌供血；3例同时关闭室间隔缺损；3例同时行二尖瓣瓣环成形术或二尖瓣置换术。手术死亡率为6.2%，平均术后随访18个月，79%的存活患者无症状。
