Aoki Masaya, Ikeno Yuki, Ibuki Keijiro, Ozawa Sayaka, Hirono Keiichi, Yoshimura Naoki
Department of Cardiovascular Surgery, 34823University of Toyama, Japan.
Department of Surgery, Division of Cardiothoracic Surgery, 12225University of Colorado School of Medicine, USA.
Asian Cardiovasc Thorac Ann. 2022 Sep;30(7):840-843. doi: 10.1177/02184923211066653. Epub 2021 Dec 6.
We present the case report of a patient who developed interventricular septal hematoma as a complication during perimembranous ventricular septal defect closure. Although cardiopulmonary bypass was re-established and the hematoma was aspirated, postoperative echocardiography revealed that the hematoma reaccumulated in the interventricular septum. She suffered from low-cardiac-output syndrome for 1 week requiring a large amount of inotropic agents. Postoperative echocardiography revealed that the interventricular septal hematoma gradually disappeared. At 1 year follow-up, Tc-tetrofosmin myocardial single-photon emission computed tomographic revealed myocardial ischemia in the inferior and septal walls. At 4 years follow-up, her cardiac function has gradually improved. She has no symptoms of heart failure with angiotensin-converting enzyme inhibitor and beta-blocker.
我们报告了1例在膜周部室间隔缺损封堵过程中发生室间隔血肿并发症的病例。尽管重新建立了体外循环并抽吸了血肿，但术后超声心动图显示血肿在室间隔再次积聚。她出现低心排血量综合征1周，需要大量的正性肌力药物。术后超声心动图显示室间隔血肿逐渐消失。在1年随访时，锝-替曲膦心肌单光子发射计算机断层扫描显示下壁和间隔壁心肌缺血。在4年随访时，她的心脏功能逐渐改善。在使用血管紧张素转换酶抑制剂和β受体阻滞剂的情况下，她没有心力衰竭的症状。
