与严重二尖瓣反流相关的心室假性动脉瘤。
Ventricular pseudoaneurysm associated with severe mitral regurgitation.
作者信息
Mallidi Hari R, Latter David A
机构信息
Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA, USA.
出版信息
Nat Clin Pract Cardiovasc Med. 2006 May;3(5):283-7; quiz 1 p following 288. doi: 10.1038/ncpcardio0545.
BACKGROUND
A 77-year-old man presented with non-ST-segment elevation myocardial infarction, congestive heart failure and cardiogenic shock. In the coronary care unit, the patient was initially stabilized by diuresis and afterload reduction. Six months previously he had experienced an episode of severe dyspnea, orthopnea and chest heaviness.
INVESTIGATIONS
Echocardiography and coronary angiography.
DIAGNOSIS
Ventricular pseudoaneurysm associated with mitral regurgitation after myocardial infarction.
MANAGEMENT
Pseudoaneurysm repair using a bovine pericardial patch, coronary artery bypass grafting of the left anterior descending and circumflex coronary artery and management of mitral regurgitation by ventricular remodeling.
背景
一名77岁男性患者出现非ST段抬高型心肌梗死、充血性心力衰竭和心源性休克。在冠心病监护病房，患者最初通过利尿和减轻后负荷得以稳定。6个月前，他曾经历一次严重的呼吸困难、端坐呼吸和胸部沉重感。
检查
超声心动图和冠状动脉造影。
诊断
心肌梗死后伴有二尖瓣反流的心室假性动脉瘤。
治疗
使用牛心包补片修复假性动脉瘤，对左前降支和左旋支冠状动脉进行冠状动脉旁路移植术，并通过心室重塑处理二尖瓣反流。
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