Vogel-Claussen Jens, Skrok Jan, Fishman Elliot K, Lima João Ac, Shah Ashish S, Bluemke David A
Russell H, Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Cardiothorac Surg. 2009 Aug 12;4:42. doi: 10.1186/1749-8090-4-42.
We report the case of a 67 year-old patient who presented with worsening chest pain and shortness of breath, four days post acute myocardial infarction. Contrast enhanced computed tomography of the chest ruled out a pulmonary embolus but revealed an unexpected small subepicardial aneurysm (SEA) in the lateral left ventricular wall which was confirmed on cardiac magnetic resonance imaging. Intraoperative palpation of the left lateral wall was guided by the cardiac MRI and CT findings and confirmed the presence of focally thinned and weakened myocardium, covered by epicardial fat. An aneurysmorrhaphy was subsequently performed in addition to coronary bypass surgery and a mitral valve repair. The patient was discharged home on post operative day eight in good condition and is feeling well 2 years after surgery.
我们报告了一例67岁患者的病例，该患者在急性心肌梗死后四天出现胸痛和呼吸急促加重的症状。胸部对比增强计算机断层扫描排除了肺栓塞，但发现左心室侧壁意外出现一个小的心外膜下动脉瘤（SEA），心脏磁共振成像证实了这一情况。术中对左心室侧壁的触诊以心脏磁共振成像和计算机断层扫描结果为指导，证实存在局部变薄和减弱的心肌，表面覆盖有心外膜脂肪。除了冠状动脉搭桥手术和二尖瓣修复外，随后还进行了动脉瘤缝合术。患者术后第八天状况良好出院，术后两年感觉良好。
