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[感染性心内膜炎所致左心室假性动脉瘤的外科治疗;1例报告]

[Surgical treatment for left ventricular false aneurysm caused by infective endocarditis; report of a case].

作者信息

Ryomoto M, Yao H, Mukai S, Yamamura M, Tanaka H, Nakagawa T, Inai Y, Yoshioka Y, Kaji M, Miyamoto T

机构信息

Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.

出版信息

Kyobu Geka. 2003 Nov;56(12):1059-61.

Abstract

A 24-year-old man who had left ventricular (LV) false aneurysm, which is caused by mitral valve infective endocarditis, underwent aneurysmectomy, direct closure of aneurysmal mouth and concomitant mitral valve replacement. Post-operative course was uneventful. It has been reported that the etiology of this false aneurysm was due to the vegetations' friction, which could have caused an initial endocardial ulceration that progressively expanded into the myocardium. The false aneurysmal wall should be completely removed in order to eliminate the possibility of recurrence of the infective endocarditis. We believe that the surgical treatment should be carried out as soon as possible after completion of diagnosis because the aneurysmal wall is usually quite thin and could rupture easily.

摘要

一名24岁男性因二尖瓣感染性心内膜炎导致左心室假性动脉瘤,接受了动脉瘤切除术、动脉瘤口直接缝合及同期二尖瓣置换术。术后过程顺利。据报道,这种假性动脉瘤的病因是赘生物的摩擦,这可能导致最初的心内膜溃疡,并逐渐扩展至心肌。为消除感染性心内膜炎复发的可能性,应彻底切除假性动脉瘤壁。我们认为,诊断完成后应尽快进行手术治疗,因为动脉瘤壁通常很薄,容易破裂。

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