急性心肌梗死后室间隔穿孔继以乳头肌破裂：静脉-动脉体外膜肺氧合的疗效

Ushioda Ryohei, Fujii Atsuko, Shirakawa Makoto, Shirasaka Tomonori, Kikuchi Shinsuke, Kamiya Hiroyuki, Kanamori Taro

Department of Cardiovascular Surgery, Kawaguchi Cardiovascular and Respiratory Hospital, Saitama, Japan.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

J Surg Case Rep. 2020 Jul 31;2020(7):rjaa188. doi: 10.1093/jscr/rjaa188. eCollection 2020 Jul.

The occurrence of multiple mechanical complications after myocardial infarction in the same patient may be extremely rare, and the surgical strategy may be very complex because each mechanical complication can be extremely fatal. The case of a patient who underwent repair of a ventricular septal perforation by venoarterial extracorporeal membrane oxygenation (VA-ECMO), then mitral valve replacement and VA-ECMO for papillary muscle rupture 2 weeks after the ventricular septal perforation repair, is reported. Immediate preoperative stabilization with VA-ECMO may play a crucial role in treating multiple mechanical complications after myocardial infarction.

同一患者心肌梗死后出现多种机械并发症的情况可能极为罕见，而且手术策略可能非常复杂，因为每种机械并发症都可能极其致命。本文报道了一例患者，该患者先通过静脉-动脉体外膜肺氧合（VA-ECMO）进行室间隔穿孔修复，然后在室间隔穿孔修复术后2周因乳头肌破裂进行二尖瓣置换及VA-ECMO治疗。术前立即使用VA-ECMO进行稳定治疗可能在治疗心肌梗死后的多种机械并发症中发挥关键作用。