Yamaguchi Shohjiro, Watanabe Go, Yamamoto Shinichiro
Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Takaramachi 13-1, Kanazawa 920-8641, Japan.
Interact Cardiovasc Thorac Surg. 2006 Aug;5(4):462-3. doi: 10.1510/icvts.2005.127001. Epub 2006 May 2.
We report a rare, rapid, huge formation of the left ventricular pseudoaneurysm after sutureless repair with GRF glue.
The case was a 70-year-old male, who received an emergency operation for a subacute left ventricular free wall rupture (LVFWR) complicated by acute myocardial infarction. At that time the left ventricle was wrapped with equine pericardium by using gelatin resorcin formaldehyde (GRF) glue (sutureless repair). The patient had been stable for 13 months but suffered acute heart failure. The left ventricular angiogram (LVG) revealed a huge left ventricular aneurysm and 75% stenosis in the middle segment of the left anterior descending artery (LAD). He had received the LVG one month before. There was a small concavity in the inferior wall of the left ventricle. A huge pseudoaneurysm had formed within one month.
A left ventricle direct patch closure, and coronary artery bypass were performed. In the pathological findings, the wall of the aneurysm was almost elastic collagen tissue.
Sutureless repair is an effective technique for subacute left ventricular free wall rupture, a left ventricular pseudoaneurysm has to be cared for the late period.
我们报告1例使用GRF胶水进行无缝合修补术后罕见、迅速形成巨大左心室假性动脉瘤的病例。
该病例为一名70岁男性，因亚急性左心室游离壁破裂（LVFWR）合并急性心肌梗死接受急诊手术。当时使用明胶间苯二酚甲醛（GRF）胶水（无缝合修补）用马心包包裹左心室。患者病情稳定13个月，但随后出现急性心力衰竭。左心室血管造影（LVG）显示巨大左心室动脉瘤，左前降支（LAD）中段狭窄75%。患者1个月前曾接受过LVG检查。左心室下壁有一个小凹陷。1个月内形成了一个巨大的假性动脉瘤。
进行了左心室直接补片闭合术和冠状动脉搭桥术。病理检查发现，动脉瘤壁几乎为弹性胶原组织。
无缝合修补术是治疗亚急性左心室游离壁破裂的有效技术，晚期必须关注左心室假性动脉瘤。
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