Narin Cüneyt, Ege Erdal, Ozkara Ahmet, Tanyeli Omer, Sarkilar Gamze, Soylu Ahmet, Sarigul Ali, Yeniterzi Mehmet
Department of Cardiovascular Surgery, Selçuk University, Faculty of Meram Medicine, Konya, Turkey.
J Card Surg. 2008 Jul-Aug;23(4):294-8. doi: 10.1111/j.1540-8191.2007.00544.x. Epub 2008 Jul 1.
Left ventricular pseudoaneurysm is a rare and frequently fatal complication of acute myocardial infarction. It occurs as a consequence of rupture of the ventricular free wall that gets confined by a portion of the pericardium. The purpose of this study was to present our surgical experience of postinfarction left ventricular pseudoaneurysms and to evaluate mid-term results.
The study population comprised five symptomatic patients diagnosed with left ventricular pseudoaneurysm and treated surgically in a short period of time. There were three males and two females. The mean age of the patients was 66.8 +/- 10.8 years. The diagnosis was made initially by echocardiography and subsequently confirmed by angiography. An additional cardiac magnetic resonance imaging study was performed in three patients. Surgical resection of the pseudoaneurysm was combined with an endoaneurysmorrhaphy procedure in all patients. Associated cardiac operations were performed in three patients. Definitive diagnosis of pseudoaneurysm was confirmed by histopathological evaluation of the excised wall in all patients.
All patients survived the operation and were discharged to home care. The mean duration of hospital stay was 11.6 +/- 4.6 days. Patients were either in class I or II of New York Heart Association classification at discharge. All patients are still being followed after surgery with a mean follow-up period of 10.4 +/- 6.6 months with no further problems.
Surgical repair is indicated in left ventricular pseudoaneurysm as it carries a high risk of rupture and sudden cardiac death. Surgical repair combined with an endoaneurysmorrhaphy procedure carries a low mortality risk and improves functional capacity.
左心室假性动脉瘤是急性心肌梗死罕见且常致命的并发症。它是心室游离壁破裂后被部分心包膜包裹所致。本研究的目的是介绍我们在心肌梗死后左心室假性动脉瘤手术方面的经验，并评估中期结果。
研究对象包括5例有症状的左心室假性动脉瘤患者，这些患者在短时间内接受了手术治疗。其中男性3例，女性2例。患者的平均年龄为66.8±10.8岁。最初通过超声心动图做出诊断，随后通过血管造影术得到证实。3例患者还进行了心脏磁共振成像检查。所有患者均采用假性动脉瘤手术切除联合心室内动脉瘤缝闭术。3例患者还进行了相关心脏手术。所有患者均通过对切除壁的组织病理学评估确诊为假性动脉瘤。
所有患者均手术存活并出院接受家庭护理。平均住院时间为11.6±4.6天。出院时患者纽约心脏协会心功能分级均为I级或II级。所有患者术后仍在接受随访，平均随访期为10.4±6.6个月，未出现进一步问题。
左心室假性动脉瘤具有破裂和心源性猝死的高风险，因此需进行手术修复。假性动脉瘤手术切除联合心室内动脉瘤缝闭术死亡率低，可改善心功能。
