Fedakar Ali, Bugra Onursal, Onk Alper, Mataraci Ilker, Eren Ercan, Zeybek Rahmi
Department of Cardiovascular Surgery, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, 34846 Kartal, Istanbul, Turkey.
Asian Cardiovasc Thorac Ann. 2010 Feb;18(1):39-43. doi: 10.1177/0218492309353988.
The outcomes of 3 different methods of repair of left ventricular pseudoaneurysm after myocardial infarction were analyzed retrospectively. The operations were carried out in 22 patients between 1985 and 2008. Repair procedures included primary closure with Teflon-pledgeted sutures, and Dacron or pericardial patches. Overall hospital mortality was 27.3% (2 patients had primary closure, 3 had a Dacron patch, and 1 had a pericardial patch). Mean postoperative bleeding was 885 mL (range, 200-4,800 mL). Mean preoperative and postoperative ejection fractions were 40% (30%-47%) and 48% (30%-65%), respectively. The overall incidence of arrhythmia was 36.4% (8 patients). The incidence of arrhythmia was lowest in the pericardial patch group, but this was not statistically significant. No significant differences in postoperative ejection fraction or hemorrhage were found among the study groups. Mean survival was 61.9 + or - 41.4 months in the 16 hospital survivors. Although the 3 techniques gave similar results, repair with an autologous pericardial patch may offer an advantage in terms of less postoperative arrhythmias.
回顾性分析了心肌梗死后左心室假性动脉瘤3种不同修复方法的结果。1985年至2008年间对22例患者实施了手术。修复程序包括用带垫片的特氟龙缝线进行一期缝合，以及使用涤纶或心包补片。总体医院死亡率为27.3%（2例患者接受一期缝合，3例使用涤纶补片，1例使用心包补片）。术后平均出血量为885毫升（范围为200 - 4800毫升）。术前和术后平均射血分数分别为40%（30% - 47%）和48%（30% - 65%）。心律失常的总体发生率为36.4%（8例患者）。心包补片组心律失常的发生率最低，但无统计学意义。各研究组术后射血分数或出血情况无显著差异。16例医院幸存者的平均生存期为61.9±41.4个月。虽然这3种技术的结果相似，但使用自体心包补片修复在减少术后心律失常方面可能具有优势。
