Department of Cardiothoracic Surgery Maastricht University Medical Center Maastricht, The Netherlands.
Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, the Netherlands.
Multimed Man Cardiothorac Surg. 2020 Nov 30;2020. doi: 10.1510/mmcts.2020.065.
The development of a postmyocardial infarction ventricular septal rupture is an uncommon but frequently fatal complication. Mortality with medical treatment only is extremely high. Septal rupture results in a left-to-right shunt, with right ventricular volume overload, increased pulmonary blood flow, and secondary volume overload of the left atrium and ventricle. Surgical treatment consists of excluding rather than excising the infarcted septum and ventricular walls. This is accomplished by performance of a left ventriculotomy through the infarcted muscle and securing a glutaraldehyde-fixed bovine pericardium patch to the endocardium of the left ventricle all around the infarcted myocardium.
心肌梗死后室间隔破裂是一种罕见但常致命的并发症。单纯药物治疗的死亡率极高。室间隔破裂导致左向右分流，右心室容量超负荷，肺血流量增加，继而左心房和左心室容量超负荷。手术治疗包括排除而非切除梗死的室间隔和心室壁。通过在梗死的心肌上进行左心室切开术，并将戊二醛固定的牛心包补片固定在整个梗死心肌的左心室心内膜上来完成这一操作。
