Gillmer D J, Odell J A, Mitha A S
Department of Cardiology, Wentworth Hospital, Durban.
S Afr Med J. 1988 Mar 5;73(5):277-8.
Between 1978 and 1984 6 cases of ventricular septal defect after myocardial infarction were referred to this hospital. All 6 patients underwent cardiac catheterisation, had severe pulmonary hypertension and large left-to-right shunts (mean 64%). They were treated with high doses of diuretics and vasodilators, and underwent delayed surgery 6 weeks after rupture. Follow-up is from 1 to 7 years. There has been 1 late, non-cardiac death. The remainder are well. In our experience patients with congestive cardiac failure complicating ventricular septal defect after infarction can be stabilized initially on diuretic and vasodilator therapy, and surgery can safely be deferred until septal fibrosis allows adequate closure.
1978年至1984年间，本院共收治6例心肌梗死后室间隔缺损患者。所有6例患者均接受了心导管检查，均有严重的肺动脉高压和大量左向右分流（平均64%）。他们接受了大剂量利尿剂和血管扩张剂治疗，并在破裂后6周接受了延迟手术。随访时间为1至7年。有1例晚期非心脏死亡。其余患者情况良好。根据我们的经验，心肌梗死后合并室间隔缺损的充血性心力衰竭患者最初可用利尿剂和血管扩张剂治疗使其病情稳定，手术可安全推迟至间隔纤维化允许充分闭合时进行。
