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1例冠状动脉搭桥术中经内镜清除左心室血栓的治疗病例。

A treatment case of endoscopic removal of left ventricular thrombus, during coronary artery bypass graft.

作者信息

Park Hyun-Seok, Ryu Se-Min, Cho Seong-Joon, Park Sung-Min, Lim Sun-Hye

机构信息

Department of Thoracic and Cardiovascular Surgery, Kangwon National University School of Medicine.

Department of Family Medicine, Kangwon National University School of Medicine.

出版信息

Korean J Thorac Cardiovasc Surg. 2014 Aug;47(4):434-6. doi: 10.5090/kjtcs.2014.47.4.434. Epub 2014 Aug 5.

Abstract

Left ventricular thrombus is a common complication related to acute myocardial infarction. Removing this with an incision of the free wall of the left ventricle may cause fatal cardiac dysfunction or arrhythmias. Furthermore, performing incision and suture on the fragile myocardium of an acute myocardial infarction patient may cause serious bleeding complications. If there is a patient with left ventricular thrombus who needs thoracotomy for another reason, the case is attempted with the thought that if effective intraventricular visualization and manipulation can be done, fatalities caused by incision and suture may be reduced. For patients undergoing cardiopulmonary bypass, if intracardiac manipulation is required, an endoscope can be used, and given the potential complications after the incision and suturing of the infarcted tissue, the benefits are deemed sufficient.

摘要

左心室血栓是急性心肌梗死的常见并发症。通过切开左心室游离壁来清除血栓可能会导致致命的心脏功能障碍或心律失常。此外,在急性心肌梗死患者脆弱的心肌上进行切开和缝合可能会导致严重的出血并发症。如果有左心室血栓患者因其他原因需要开胸手术,会设想如果能够进行有效的心室内可视化和操作,或许可以减少切开和缝合导致的死亡。对于接受体外循环的患者,如果需要进行心内操作,可以使用内窥镜,鉴于梗死组织切开和缝合后存在潜在并发症,认为其益处是足够的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9ae/4157515/0247e4ea433a/kjtcvs-47-434f1.jpg

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