Dorobantu Lucian Florin, Stiru Ovidiu, Iliescu Vlad Anton
a Department of Cardiovascular Surgery , Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases , Bucharest , Romania.
Acta Chir Belg. 2016 Feb;116(1):58-61. doi: 10.1080/00015458.2016.1139826.
Introduction The association between both left and right ventricular free wall ruptures (FWR) and post-infarction anterior ventricular septal defect (VSD) is an exceptional situation. Case report We present the case of a patient who developed a VSD and two FWRs (of the left and right ventricle, respectively) shortly after the onset of an anterior AMI. We surgically closed this complex rupture using the cohesive double patch technique with two Teflon patches combined with an infarct exclusion technique. The left and right ventricular patches were attached cohesively to the septal wall and the infarcted area was excluded without reducing the left ventricular cavity. Conclusion Association between post-infarction ventricular septal rupture and both left and right free wall ruptures are a very rare and dangerous situation. The modified cohesive double patch technique associated the modified Cooley technique seems to be the correct surgical solution.
引言 左、右心室游离壁破裂(FWR)与心肌梗死后前室间隔缺损(VSD)之间的关联是一种罕见情况。病例报告 我们报告一例患者,该患者在前壁急性心肌梗死(AMI)发作后不久出现室间隔缺损和两个游离壁破裂(分别为左心室和右心室)。我们采用粘性双补片技术,使用两个聚四氟乙烯补片并结合梗死灶切除术,通过手术闭合了这种复杂的破裂。左、右心室补片粘性地附着于间隔壁,梗死区域被切除,而未缩小左心室腔。结论 心肌梗死后室间隔破裂与左、右游离壁破裂同时存在是一种非常罕见且危险的情况。改良的粘性双补片技术联合改良的库利技术似乎是正确的手术解决方案。