Tanaka Kei, Mashiko K, Kawada N
Department of Cardiovascular Surgery, Fuji City General Hospital, Fuji, Japan.
Kyobu Geka. 2004 Aug;57(9):885-8.
The left ventricular wall rupture is not only a rare complication after mitral valve replacement, but also a high mortality disease. We have encountered a case of this complication after removal of the extracorporeal circulation in an octogenarian female after mitral valve replacement with Carpentier-Edwards (25 mm). It could be successfully repaired from outside the heart on the cardiopulmonary bypass without second cardiac arrest. Repair from inside the heart using extracorporeal circulation and cardioplesia is generally recommended because of the accuracy. However, second cardiac arrest might be a risk of postoperative complications in octogenarians. Hence, prevention is the most important. And operative strategy for the repair is also important in these patients.
左心室壁破裂不仅是二尖瓣置换术后罕见的并发症,也是一种高致死性疾病。我们遇到了一例这样的并发症,发生在一位80岁女性接受Carpentier-Edwards(25mm)二尖瓣置换术后体外循环撤除时。该病例在体外循环下从心脏外部成功修复,无需再次心脏停搏。由于操作精确性,一般建议在体外循环和心脏停搏下从心脏内部进行修复。然而,再次心脏停搏可能会给80岁高龄患者带来术后并发症风险。因此,预防最为重要。而且对于这些患者,修复的手术策略也很重要。