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[右心室发育不良所致抗药型室性心动过速。1例干预6年后手术康复的报告]

[Resistant ventricular tachycardia caused by right ventricular dysplasia. A case of surgical recovery reported 6 years after intervention].

作者信息

Trigano J A, Nasta H, Michaud J L, Houel J, Jouven J C, Jouve A, Torresani J

出版信息

Arch Mal Coeur Vaiss. 1983 Jul;76(7):852-7.

PMID:6412656
Abstract

A 52 year old patient with no previous medical history had an attack of ventricular tachycardia, the configuration of which showed left sided delay. Electrical reduction was followed by multiple recurrences. There were ST-T wave changes over the right precordium on the basal ECG. The hydro-electrolytic equilibrium was normal. Coronary angiography and selective left ventricular cineangiography were also normal. Right angiocardiography showed an aneurysmal deformation of the pulmonary infundibulum. The recurrence of attacks over a two year period led to several hospital admissions, demonstrating the failure of antiarrhytmic therapy. The attacks became so frequent in the last three months that surgery was undertaken. Epicardial mapping showed delayed potentials over the pulmonary infundibulum and surgery consisted in resection of the abnormal infundibular zone. The macro- and microscopic pathological findings were of wall thinning and muscular degeneration with fibrosis and fatty infiltration. The authors discuss the relationship between right ventricular dysplasia and a localised form of Uhl's anomaly. Six years after surgery the patient has had no recurrence of the arrhythmia or shown signs of cardiac failure in the absence of any drug therapy.

摘要

一名52岁、既往无病史的患者发作室性心动过速,其形态显示左侧延迟。电复律后多次复发。基础心电图显示右胸前导联有ST-T波改变。水电解质平衡正常。冠状动脉造影和选择性左心室造影也正常。右心造影显示肺动脉漏斗部呈瘤样变形。两年内发作反复出现,导致多次住院,表明抗心律失常治疗无效。在过去三个月里,发作变得非常频繁,于是进行了手术。心外膜标测显示肺动脉漏斗部有延迟电位,手术包括切除异常的漏斗部区域。大体和显微镜下病理结果为壁变薄、肌肉变性伴纤维化和脂肪浸润。作者讨论了右心室发育不良与局限性乌尔畸形之间的关系。手术后六年,患者未再出现心律失常,在未接受任何药物治疗的情况下也未出现心力衰竭迹象。

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