Ashfaq Awais, Sharif Hasanat
Department of Surgery, Aga Khan University, Karachi.
J Pak Med Assoc. 2012 Aug;62(8):861-5.
To outline the outcome and management of patients with acute myocardial infarction presenting with mechanical complications such as post-infarction ventricular septal defect, mitral regurgitation and left ventricular rupture.
The retrospective study, conducted in September and October, 2010 at the Aga Khan University Hospital, Karachi, included cases from January 1990 to December 2009. Only 18 cases were found who had presented with such complications. They were assessed for demographics as well as pre-operative, per-operative and post-operative management patterns. Data was analysed using SPSS version 17.0.
Out of the 18 patients, 10 had post-infarction ventricular septal defect, while 8 had mitral regurgitation defects. The mean time from myocardial infarction to the diagnosis of mechanical complications was 5.28 +/- 4.07 days, and from diagnosis to repair was 2.00 +/- 1.49 days. Overall, there were 3 in-hospital mortalities.
The optimal timing of surgical intervention has always remained debatable. A high-level of clinical suspicion and earlier intervention can reduce morbidities and mortalities.
概述急性心肌梗死伴机械性并发症（如心肌梗死后室间隔缺损、二尖瓣反流和左心室破裂）患者的治疗结果及管理情况。
这项回顾性研究于2010年9月和10月在卡拉奇的阿迦汗大学医院进行，纳入了1990年1月至2009年12月期间的病例。仅发现18例出现此类并发症的患者。对他们进行了人口统计学评估以及术前、术中及术后管理模式评估。使用SPSS 17.0版对数据进行分析。
18例患者中，10例有心肌梗死后室间隔缺损，8例有二尖瓣反流缺损。从心肌梗死到诊断出机械性并发症的平均时间为5.28±4.07天，从诊断到修复的平均时间为2.00±1.49天。总体而言，有3例院内死亡病例。
手术干预的最佳时机一直存在争议。高度的临床怀疑和早期干预可降低发病率和死亡率。
