Otterstad J E, Forfang K, Vatne K, Frøysaker T
Scand J Thorac Cardiovasc Surg. 1982;16(2):205-8. doi: 10.3109/14017438209101812.
A 62-year-old male developed a large posterior left ventricular aneurysm diagnosed 6 months after a sustained myocardial infarction. Coronary angiography revealed a proximal occlusion of the circumflex artery, two 75% stenoses of the right coronary artery and a normal left anterior descending artery. The main clinical indication for surgery was residual bouts of ventricular tachycardia. A successful "mechanical conversion" of this arrhythmia by means of light precordial knocks in the apex region is reported. In this way the patient could be prepared for surgery without using myocardial depressant drugs. The aneurysm was resected, encircling endocardial ventriculotomy was performed and the right coronary artery was grafted. Nine months after the operation the patient is well without the need for antiarrhythmic drugs. The rarity of this condition is stressed and the possible mechanisms of ventricular tachycardia and its treatment in this particular case are discussed.
一名62岁男性在持续性心肌梗死后6个月被诊断出患有巨大的左心室后壁动脉瘤。冠状动脉造影显示回旋支近端闭塞，右冠状动脉有两处75%的狭窄，左前降支正常。手术的主要临床指征是室性心动过速反复发作。报告了通过在心尖区轻轻叩击成功“机械性转复”这种心律失常的情况。通过这种方式，患者可以在不使用心肌抑制药物的情况下为手术做准备。切除动脉瘤，进行心内膜环行心室切开术，并移植右冠状动脉。术后9个月，患者情况良好，无需使用抗心律失常药物。强调了这种情况的罕见性，并讨论了该特定病例中室性心动过速的可能机制及其治疗方法。
