Chernyavskiy Alexander M, Marchenko Andrey V, Lomivorotov Vladimir V, Doronin Dmitriy, Alsov Sergey A, Nesmachnyy Alexey
Aorta and Coronary Arteries Surgery Department, Research Institute of Circulation Pathology, Novosibirsk 630055, Russia.
Tex Heart Inst J. 2012;39(5):627-9.
Nine months after sustaining a transmural anteroseptal myocardial infarction, a 45-year-old man presented with ischemic heart disease, severe mitral valve insufficiency, New York Heart Association functional class IV congestive heart failure, and a left ventricular aneurysm. Coronary angiography revealed 3-vessel disease. Echocardiography showed severe left ventricular impairment, pronounced thrombosis in the left ventricular apex, and low myocardial reserve. To reduce the high risk of performing left ventricular and mitral valve reconstruction concurrently with revascularization, we decided to perform ventricular reconstruction and to implant a Berlin Heart INCOR left ventricular assist device as a bridge to heart transplantation. The patient had an uncomplicated recovery, was discharged from the hospital with symptomatic improvement after 20 days, and was placed on the list for heart transplantation. We describe the patient's case, the surgical procedure, and the reasoning behind the chosen course of treatment.
一名45岁男性在发生透壁性前间隔心肌梗死后9个月，出现缺血性心脏病、严重二尖瓣关闭不全、纽约心脏协会心功能IV级充血性心力衰竭及左心室室壁瘤。冠状动脉造影显示三支血管病变。超声心动图显示严重左心室功能损害、左心室心尖部有明显血栓形成以及心肌储备功能低下。为降低在血运重建的同时进行左心室和二尖瓣重建的高风险，我们决定进行心室重建并植入柏林心脏INCOR左心室辅助装置作为心脏移植的过渡。患者恢复过程顺利，20天后症状改善出院，并被列入心脏移植名单。我们描述了该患者的病例、手术过程以及所选治疗方案背后的理由。
