Takagi H, Terada Y, Shimoyama Y, Ino T, Wanibuchi Y, Furuta S
Department of Cardiac Surgery, Mitsui Memorial Hospital.
Kyobu Geka. 1990 Feb;43(2):97-101.
Left ventricular free wall rupture secondary to acute myocardial infarction is almost invariably fatal. This report is the case presentation of a successful repair of left ventricular free wall rupture. A 55-year-old man, with a diagnosis of acute infero-lateral myocardial infarction, was transferred from another hospital to our CCU having recurrent chest pain on the fourth day after infarction. Shortly after admission, he lost his consciousness and fell into cardiogenic shock. Echocardiography showed a large pericardial fluid. He was immediately transferred to the operating room with the diagnosis of the heart rupture. After opening the pericardium containing 200 cc of blood, cardiac tamponade was relieved. The posterolateral portion of the left ventricle was found to be bluishly discolored, with a 8 mm-long tear of epicardium. Using cardiopulmonary bypass, the tear was closed with Teflon-reinforced sutures. The post-operative course was uneventful.
急性心肌梗死继发左心室游离壁破裂几乎总是致命的。本报告是一例成功修复左心室游离壁破裂的病例介绍。一名55岁男性,诊断为急性下侧壁心肌梗死,在梗死第四天因反复胸痛从另一家医院转入我院CCU。入院后不久,他失去意识并陷入心源性休克。超声心动图显示心包大量积液。他被立即诊断为心脏破裂并转入手术室。打开心包发现有200毫升血液,解除了心脏压塞。发现左心室后外侧部分呈青紫色,有一条8毫米长的心外膜撕裂口。使用体外循环,用特氟龙加固缝线缝合撕裂口。术后过程顺利。