Sánchez-Luna Juan Pablo, Amat-Santos Ignacio J
Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, España; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
Rev Esp Cardiol (Engl Ed). 2023 May;76(5):362-369. doi: 10.1016/j.rec.2022.11.015. Epub 2023 Feb 21.
Mechanical complications following a myocardial infarction are uncommon, but with dramatic consequences and high mortality. The left ventricle is the most often affected cardiac chamber and complications can be classified according to the timing in early (from days to first weeks) or late complications (from weeks to years). Despite the decrease in the incidence of these complications thank to primary percutaneous coronary intervention programs -wherever this option is available-, the mortality is still significant and these infrequent complications are an emergent scenario and one of the most important causes of mortality at short term in patients with myocardial infarction. Mechanical circulatory support devices, especially if minimally invasive implantation is used avoiding thoracotomy, have improved the prognosis of these patients by providing stability until definitive treatment can be applied. On the other hand, the growing experience in transcatheter interventions for the treatment of ventricular septal rupture or acute mitral regurgitation has been associated to an improvement in their results, even though prospective clinical evidence is still missing.
心肌梗死后的机械性并发症并不常见，但后果严重且死亡率高。左心室是最常受影响的心腔，并发症可根据发生时间分为早期（从数天至最初几周）或晚期并发症（从数周至数年）。尽管由于初级经皮冠状动脉介入治疗项目（只要有此选择），这些并发症的发生率有所下降，但死亡率仍然很高，这些罕见的并发症是一种紧急情况，也是心肌梗死患者短期死亡的最重要原因之一。机械循环支持设备，特别是如果采用微创植入避免开胸手术，通过在能够应用确定性治疗之前提供稳定性，改善了这些患者的预后。另一方面，经导管介入治疗室间隔破裂或急性二尖瓣反流的经验不断增加，尽管仍缺乏前瞻性临床证据，但已与治疗效果的改善相关。
