Stewart S, Huddle R, Stuard I, Schreiner B F, DeWeese J A
Ann Thorac Surg. 1981 Mar;31(3):259-65. doi: 10.1016/s0003-4975(10)60938-1.
Four patients are presented in whom either a false aneurysm or a "pseudo-false" aneurysm of the left ventricle developed following a myocardial infarction. False aneurysms of the left ventricle are unusual and are distinctly different from the more common true aneurysms. A false aneurysm is the result of a contained hematoma dissecting, into a transmural infarct. It communicates with the left ventricle through a small orifice. Previous descriptions of false aneurysms have stressed that their wall consists of pericardium and mural thrombus and lack identifiable epicardial or myocardial elements. Two pseudo-false aneurysms are described. They communicated with the left ventricle through a small orifice but their wall contained myocardial tissue. False aneurysms have a tendency to rupture and therefore their presence alone is an indication for operation. One of the pseudo-false aneurysms discussed ruptured into the right ventricle. The operation for false aneurysm may be simpler than that for true aneurysm since it might be possible to close the small communication into the left ventricle without resecting the entire aneurysm wall.
本文报告了4例心肌梗死后发生左心室假性动脉瘤或“假-假性”动脉瘤的患者。左心室假性动脉瘤并不常见，与更常见的真性动脉瘤明显不同。假性动脉瘤是局限性血肿穿破至透壁性梗死灶内形成的，通过一个小孔与左心室相通。既往对假性动脉瘤的描述强调其壁由心包和壁层血栓组成，缺乏可识别的心外膜或心肌成分。本文描述了2例假-假性动脉瘤，它们通过一个小孔与左心室相通，但其壁含有心肌组织。假性动脉瘤有破裂倾向，因此仅其存在就提示需要手术治疗。文中讨论的1例假-假性动脉瘤破裂入右心室。假性动脉瘤的手术可能比真性动脉瘤的手术更简单，因为有可能不切除整个动脉瘤壁而封闭与左心室的小通道。
