Okies J E, Dietl C, Garrison H B, Starr A
J Thorac Cardiovasc Surg. 1978 Feb;75(2):255-60.
Fifty-seven patients have undergone ventricular aneurysm resection with a mortality rate of 10 percent. Recent surgical trends have been toward complete revascularization and treatment of concomitant disorders when present. Although the early mortality rate may be favorable influenced by these maneuvers, analysis of survivors reveals no significant difference in survival between the group that had concomitant coronary artery bypass and the group that had aneurysm resection alone (84 percent versus 78 percent). There were significantly more asymptomatic patients in the revascularized group, however (74 percent versus 53 percent). Analysis of hospital deaths revealed nearly all to be seconary to low output syndrome, arrhythmia, myocardial infarction, or a combination of the three. Late death was due to either congestive heart failure or a myocardial infarction in all but one case. Seventy-seven percent of operative survivors are asymptomatic. Late morbidity is usually related to ungrafted or progressive coronary artery disease and generally has been successfully managed by reoperation.
57例患者接受了心室动脉瘤切除术,死亡率为10%。近期的手术趋势是进行完全血运重建,并在存在合并症时进行治疗。尽管这些操作可能对早期死亡率产生有利影响,但对幸存者的分析显示,接受同期冠状动脉搭桥术的组和仅接受动脉瘤切除术的组在生存率上没有显著差异(分别为84%和78%)。然而,血运重建组中无症状患者明显更多(分别为74%和53%)。对医院死亡病例的分析显示,几乎所有死亡均继发于低心排血量综合征、心律失常、心肌梗死或三者的组合。除1例病例外,晚期死亡均归因于充血性心力衰竭或心肌梗死。77%的手术幸存者无症状。晚期并发症通常与未搭桥或进展性冠状动脉疾病有关,一般通过再次手术成功处理。