Ollitrault J, Langella B, Favereau X, Le Guerrier A, Rioux C, Daubert J C, Gouffault J
Ann Cardiol Angeiol (Paris). 1985 Apr 30;34(4 Pt 2):297-301.
The authors report two cases of fissures of a left ventricular aneurysm diagnosed on the 8th and 21st days following an anterior myocardial infarction. In both cases, the clinical presentation consisted of a new episode of pain associated with a low cardiac output syndrome and adiastole. The diagnosis was confirmed by the simultaneous discovery of a pericardial effusion and a left ventricular aneurysm on echocardiography and cardiac catheterisation. An emergency operation, with circulatory assistance by means of intra-aortic counter-pressure, was performed and the infarcted area was excised. The post-operative course was uncomplicated in one case, but the other patient developed a false aneurysm of the left ventricle, requiring a second operation. The long term results were excellent with a follow-up of 30 months and 12 months respectively.
作者报告了两例左心室动脉瘤破裂病例,分别在急性前壁心肌梗死后第8天和第21天确诊。两例患者的临床表现均为新发疼痛,伴有低心排血量综合征和心脏舒张期停止。通过超声心动图和心导管检查同时发现心包积液和左心室动脉瘤,从而确诊。均实施了紧急手术,术中采用主动脉内反搏进行循环辅助,并切除梗死区域。其中一例患者术后恢复顺利,但另一例患者出现左心室假性动脉瘤,需要再次手术。分别随访30个月和12个月,长期效果良好。