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经心房修复心肌梗死后室间隔后下部破裂

Transatrial Repair of Post-infarction Posterior Ventricular Septal Rupture.

作者信息

Lee Weon-Yong, Kim Sung Jun, Kim Kun-Il, Lee Jae-Woong, Kim Hyoung Soo, Lee Hee Sung, Cho Sung-Woo

机构信息

Department of Thoracic and Cardiovascular Surgery, Sacred Heart Hospital, College of Medicine, Hallym University, Korea.

出版信息

Korean J Thorac Cardiovasc Surg. 2011 Apr;44(2):186-8. doi: 10.5090/kjtcs.2011.44.2.186. Epub 2011 Apr 14.

Abstract

Ventricular septal rupture (VSR) is a rare but lethal complication of myocardial infarction. The event occurs 2~8 days after an infarction and often precipitates cardiogenic shock. Post myocardial infarction VSR is known for difficult to repair. Especially, Transmural myocardial infarction involved in the posterior VSD area, exposure of the affected site is difficult and postoperative mortality rate is high. We have experienced a case of a 75-year-old female patient who suffered posterior VSD due to acute myocardial infarction, and attained good result by approaching the lesion through right atrial incision and repaired the defect by using patch closure technique.

摘要

室间隔破裂(VSR)是心肌梗死罕见但致命的并发症。该事件发生在心肌梗死后2至8天,常引发心源性休克。心肌梗死后的室间隔破裂以修复困难著称。特别是,累及后室间隔缺损区域的透壁性心肌梗死,病变部位暴露困难且术后死亡率高。我们遇到过一例75岁女性患者,因急性心肌梗死发生后室间隔缺损,通过右心房切口接近病变部位并采用补片修补技术修复缺损,取得了良好效果。

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本文引用的文献

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Postinfarction ventricular septal rupture: early repair through the right atrial approach.
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Delayed repair of an acquired posterior septal defect through a right atrial approach.
Ann Thorac Surg. 1986 Aug;42(2):208-9. doi: 10.1016/s0003-4975(10)60521-8.
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Acute postinfarction septal rupture: long-term results.急性心肌梗死后室间隔破裂:长期结果
Ann Thorac Surg. 1991 Sep;52(3):474-8. doi: 10.1016/0003-4975(91)90908-9.

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