Flores Covarrubias S E, Acoltzin Vidal C, Nava Lopez G, Palacios Macedo X
Prensa Med Mex. 1979 Nov-Dec;44(11-12):227-33.
This is a report of the first four cases of left ventricle aneurysm of the posterior and inferior segments successfully treated surgically in the Hospital de Cardiología y Neumología del Centro Médico Nacional, México D. F., and represent the twelve per cent of all realized aneurysmectomies. The patients were all men with 57 years mean age, and a previous history of posteroinferior myocardial infarction, complicated in three of them with angor and severe ventricle arrythmias; chest X ray in lateral view showed a bump of the posteroinferior border of the cardiac silhouette; the echocardiography increase in the ventricular diameter below the mitral valve; the ventriculography made evident a diastolic bulging with systolic expansion of posterior and inferior segments of the left ventricle and no mitral regurgitation; selective coronary arteriography showed a dominant right pattern with 100 per cent proximal occlusion. Aneurysmectomy was done in all four cases and aortocoronary by-pass in two. The posteromedial papilar muscle was found respected in all cases and in two cases a mural thrombus was detected.
这是墨西哥城国家医学中心心脏病学与肺病医院成功实施手术治疗的首例4例后下节段左心室动脉瘤报告，占所有已实施动脉瘤切除术的12%。患者均为男性，平均年龄57岁，既往有后下壁心肌梗死病史，其中3例并发心绞痛和严重室性心律失常；胸部侧位X线片显示心脏轮廓后下边界有隆起；超声心动图显示二尖瓣以下心室直径增大；心室造影显示左心室后下节段舒张期膨出伴收缩期扩张，无二尖瓣反流；选择性冠状动脉造影显示右优势型，近端闭塞100%。4例均行动脉瘤切除术，2例行主动脉冠状动脉搭桥术。所有病例均发现后内侧乳头肌未受侵犯，2例检测到壁血栓。
