Ollivier J P, Boschat J, Gandjbakhch I, Meudic A, Blanc J J, Penther P, Cabrol C
Arch Mal Coeur Vaiss. 1983 Jun;76(6):747-50.
A 48 year old man, victim of a serious road traffic accident (multiple limb fractures, closed trauma of the left hemithorax) was immediately diagnosed as having a systolic regurgitant murmur. The initial ECG recordings showed anterior subepicardial ischemia, and later, a low antero-septal and apical infarction. The hemodynamic status progressively deteriorated, leading to catheterisation 7 months after the accident showing an inferiorly situated VSD (oxymetry and dye dilution techniques). Angiography visualised the traumatic rupture of the lower part of the septum and an inferior posterior left ventricular aneurysm. AT surgery, the septal rupture was repaired by a Dacron patch and a false aneurysm was plicated. The patient was asymptomatic after surgery, and control catheterisation and angiography one year later showed the absence of a residual shunt and good movement of the inferior posterior left ventricular wall. The lesional mechanisms associated instantaneous septal rupture by deceleration, contusion of the apex and progressive development of an inferior posterior wall false aneurysm.
一名48岁男性，在严重道路交通事故中受伤（多处肢体骨折、左半胸闭合性创伤），被立即诊断出有收缩期反流杂音。最初的心电图记录显示前壁心外膜下缺血，后来出现前间隔下部和心尖部梗死。血流动力学状态逐渐恶化，事故7个月后进行心导管检查显示有位于下方的室间隔缺损（血氧测定和染料稀释技术）。血管造影显示室间隔下部外伤性破裂以及左心室下后壁假性动脉瘤。在手术中，用涤纶补片修复室间隔破裂，并将假性动脉瘤折叠起来。患者术后无症状，一年后的对照心导管检查和血管造影显示无残余分流，左心室下后壁运动良好。损伤机制包括减速导致的瞬间室间隔破裂、心尖部挫伤以及下后壁假性动脉瘤的逐渐形成。
