Guilmet D, Popoff G, Dubois C, Tawil N, Bachet J, Goudot B, Guermonprez J L, Brodaty D, Schlumberger S
Arch Mal Coeur Vaiss. 1984 Aug;77(8):953-8.
The classical surgical techniques used in post-myocardial infarction left ventricular aneurysms consist in resecting as much as possible of visible fibrous tissues and closure of the two borders by "U"--shaped sutures supported by a Teflon bond. There are two drawbacks to this approach: resection often involves the surface arterial network which often has a significant role to play in vascularising the remaining myocardium; fibrous, akinetic or dyskinetic zones of the anterior 2/3 of the interventricular septum cannot be resected. The proposed technique consists in limiting the surface of resection and in lowering the left border of the aneurysm as far as the posterior 1/3 of the septum. The septum is then sutured over the aneurysm to the antero-lateral wall of the left ventricle. Ten patients were operated using this technique: there were no operative deaths; preoperative cardiac failure regressed in 4 out of 5 patients; one patient was operated for unstable ventricular tachycardia, the arrhythmias disappeared after surgery; one patient operated during the 3rd week for left ventricular pseudo-aneurysm required intra-aortic balloon pumping and developed episodes of VT which finally resolved.
用于心肌梗死后左心室室壁瘤的经典外科技术包括尽可能切除可见的纤维组织，并通过由特氟龙垫片支撑的“U”形缝线闭合两个边缘。这种方法有两个缺点：切除往往涉及表面动脉网络，而该网络在为剩余心肌供血方面通常起着重要作用；室间隔前2/3的纤维性、运动不能或运动障碍区域无法切除。所提出的技术包括限制切除表面，并将室壁瘤的左边缘降低至隔的后1/3。然后将隔膜在室壁瘤上方缝合至左心室的前外侧壁。10例患者采用该技术进行手术：无手术死亡；5例患者中有4例术前心力衰竭症状消退；1例患者因不稳定室性心动过速接受手术，术后心律失常消失；1例在第3周因左心室假性室壁瘤接受手术的患者需要主动脉内球囊泵辅助，并出现室性心动过速发作，最终得以解决。
