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心肌梗死后左心室假性动脉瘤的外科治疗

Surgical treatment of false aneurysm of the left ventricle after myocardial infarction.

作者信息

Shabbo F P, Dymond D S, Rees G M, Hill I M

出版信息

Thorax. 1983 Jan;38(1):25-30. doi: 10.1136/thx.38.1.25.

Abstract

Rupture of the left ventricle after myocardial infarction results either in sudden death from cardiac tamponade or, when pericardial adhesions are present, in bleeding that is confined to a limited space, which gradually expands as the blood flows through a small communicating orifice under high pressure, forming a false aneurysm. In three such patients a false aneurysm of the left ventricle after myocardial infarction was successfully treated by operation. The interval from the initiating event to the time of surgery averaged 10 months. Two of the patients had pericarditis and all presented at some stage of the illness with tachyarrhythmias and cardiac failure. All the patients survived operation and have improved functionally. Because of the propensity of false aneurysms to rupture, early diagnosis and aggressive surgical treatment are recommended.

摘要

心肌梗死后左心室破裂,要么导致心脏压塞引起猝死,要么在心包粘连存在时,出血局限于有限空间,随着血液在高压下通过一个小的连通孔流动,该空间逐渐扩大,形成假性动脉瘤。在3例此类患者中,心肌梗死后左心室假性动脉瘤经手术成功治疗。从起始事件到手术时间的间隔平均为10个月。2例患者患有心包炎,所有患者在疾病的某个阶段均出现快速性心律失常和心力衰竭。所有患者手术后均存活且功能有所改善。由于假性动脉瘤有破裂倾向,建议早期诊断并积极进行手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d31e/459479/f5a2eb191fc4/thorax00205-0035-a.jpg

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