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[1例因乳头肌破裂导致急性心肌梗死后二尖瓣关闭不全的手术病例]

[A case of operation for acute postinfarction mitral insufficiency due to papillary muscle rupture].

作者信息

Higuchi K, Konishi T, Shigeta O, Fukata M, Okuwaki H, Makuuchi H

机构信息

Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1994 Sep;42(9):1355-60.

PMID:7989797
Abstract

A 75-year-old man was brought to hospital with complaining of chest pain. He was diagnosed acute myocardial infarction and treated medically using thrombolytic drugs. Without chest pain relieved, cardiac catheterization revealed three coronary vessel disease and severe mitral insufficiency (MR). MR was diagnosed due to papillary muscle rupture by echocardiography. After being transferred to our hospital, the patient developed in shock and underwent emergency operation with IABP inserted. Triple CABGs (to LAD, PD and 4PL) and mitral valve replacement were performed using saphenous vein grafts and a mechanical valve (Carbomedicus 25 M). The patient recovered gradually and discharged one and a half month after operation.

摘要

一名75岁男性因胸痛入院。他被诊断为急性心肌梗死,并接受了溶栓药物治疗。胸痛未缓解,心脏导管检查显示三支冠状动脉病变和严重二尖瓣关闭不全(MR)。经超声心动图诊断MR是由于乳头肌破裂所致。转至我院后,患者出现休克,接受了插入主动脉内球囊反搏(IABP)的急诊手术。使用大隐静脉移植物和机械瓣膜(Carbomedicus 25 M)进行了三支冠状动脉旁路移植术(至左前降支、后降支和第四钝缘支)和二尖瓣置换术。患者逐渐康复,术后一个半月出院。

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