Slama R, Piwnica A, Masquet C, Beaufils P, Bovrain Y
Arch Mal Coeur Vaiss. 1977 Jun;70(6):557-64.
Over the last three years, thanks on the one hand to improvements in surgical techniques and ressuscitation, and on the other to assisted circulation using the intra-aortic balloon, which allows improved preoperative preparation of the patients, urgent medicosurgical treatment of the mechanical complications of infarction has improved the prognosis by comparison with the recent past. During the above period, our figures for operative intervention during the first two weeks after an acute infarction have been as follows: 1. Twenty nine cases of septal perforation (17 of which had previously had assisted circulation by balloon): there were 8 immediate deaths and 8 successful cases (no secondary deaths over a follow-up period of from 2 to 41 months). In all these cases, the surgeon approached the perforation by way of the left ventricle. No patient required an additional bypass procedure. Where indicated, assisted circulation by means of a balloon should not be continued for more than a few days. If there is no improvement with its use, it seems unreasonable to proceed to surgery regardless. 2. Ten cases of acute mitral incompetence; 8 were due to ruptured papillary muscle and two to mal function. 5 patients out of the 10 had required circulatory assistance by balloon preoperatively. There were 2 immediate deaths and 8 successful cases, with one secondary death (follow-up period of between 2 and 37 months).
在过去三年中，一方面由于外科技术和复苏技术的改进，另一方面由于使用主动脉内球囊进行辅助循环，使得患者术前准备得到改善，与过去相比，急性心肌梗死机械并发症的紧急药物手术治疗改善了预后。在上述期间，我们急性心肌梗死后前两周内手术干预的数据如下：1. 29例室间隔穿孔（其中17例先前已通过球囊进行辅助循环）：有8例即刻死亡，8例成功病例（在2至41个月的随访期内无二次死亡）。在所有这些病例中，外科医生通过左心室途径处理穿孔。没有患者需要额外的搭桥手术。在有指征的情况下，通过球囊进行的辅助循环不应持续超过几天。如果使用后没有改善，无论如何进行手术似乎都不合理。2. 10例急性二尖瓣关闭不全；8例是由于乳头肌破裂，2例是由于功能障碍。10例患者中有5例术前需要通过球囊进行循环辅助。有2例即刻死亡，8例成功病例，1例二次死亡（随访期为2至37个月）。
