Kazama S, Sonoda K, Imai H, Ishihara A
Kyobu Geka. 1989 Jan;42(1):29-31.
The cases of two patients with cardiac rupture secondary to left ventricular venting are reported. In the first patient, who had an aortocoronary bypass grafting, rupture was found in the posterolateral wall of the left ventricle just before closing the chest. It was successfully managed by placing sutures. The cause of rupture was thought to be the advancing venting cannula tip introduced into the left ventricle from the superior right pulmonary vein. In the second patient, who had MVR, AVR, and VSD and ASD closure, rupture occurred in the posterior wall of the left atrium on the 4th postoperative day. The patient died instantly because of profound hemorrhagic shock. Rupture of the left atrium was thought to have occurred secondary to distension of the left atrial wall incurred by lifting the unusually large heart for inserting and removing the venting cannula. These experiences made us decide to abandon routine left ventricular venting.
报告了两例因左心室排气导致心脏破裂的病例。第一例患者接受了主动脉冠状动脉搭桥术,在关胸前夕发现左心室后外侧壁破裂。通过缝合成功处理。破裂原因被认为是从右上肺静脉插入左心室的排气插管尖端推进所致。第二例患者接受了二尖瓣置换术、主动脉瓣置换术以及室间隔缺损和房间隔缺损修补术,术后第4天左心房后壁发生破裂。患者因严重失血性休克立即死亡。左心房破裂被认为是由于抬起异常大的心脏插入和拔出排气插管导致左心房壁扩张继发所致。这些经历使我们决定放弃常规的左心室排气。