Natarajan M K, Salerno T A, Burke B, Chiu B, Armstrong P W
St Michael's Hospital, University of Toronto, Ontario.
Can J Cardiol. 1994 Nov;10(9):927-31.
False aneurysms of the left ventricle are a rare complication of myocardial infarction. They pose a high risk of cardiac rupture and death in the immediate stages following infarction. The long term fate of these aneurysms is less clear. Based on early reports, the current practice is to resect all false aneurysms regardless of their age. Three patients were found to have false aneurysms several years (seven to 12) following their index infarction. Two of the patients were asymptomatic at presentation and their aneurysms were discovered by echocardiography. All three patients underwent successful surgical repair. The literature on false aneurysms is reviewed and analyzed. With the wide availability of high quality noninvasive imaging there has been an increase in the reporting of unsuspected false aneurysms in the past decade. The need for prophylactic aneurysectomy of stable asymptomatic chronic false ventricular aneurysms is not well supported by available data in the literature. A strategy of conservative management with noninvasive follow-up may be a more appropriate alternative.
左心室假性动脉瘤是心肌梗死的一种罕见并发症。在梗死发生后的即刻阶段，它们会带来心脏破裂和死亡的高风险。这些动脉瘤的长期转归尚不清楚。基于早期报告，目前的做法是切除所有假性动脉瘤，无论其存在时间长短。三名患者在首次心肌梗死后数年（7至12年）被发现患有假性动脉瘤。其中两名患者在就诊时无症状，其动脉瘤通过超声心动图发现。所有三名患者均接受了成功的手术修复。对有关假性动脉瘤的文献进行了回顾和分析。随着高质量无创成像技术的广泛应用，在过去十年中，未被怀疑的假性动脉瘤的报告有所增加。现有文献数据并未充分支持对稳定无症状的慢性假性心室动脉瘤进行预防性动脉瘤切除术。采用无创随访的保守管理策略可能是更合适的选择。
