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[左心室流出道动态梗阻:外科手术问题]

[Dynamic obstruction of the left ventricular outflow tract: surgical problems].

作者信息

Zünd G, Pasic M, Carrel T, von Segesser L K, Jenni R, Turina M

机构信息

Klinik für Herz- und Gefässchirurgie, Universitätsspital Zürich.

出版信息

Schweiz Rundsch Med Prax. 1994 May 10;83(19):570-2.

PMID:8202656
Abstract

Dynamic subaortic obstruction caused by septal hypertrophy may worsen the hemodynamics in some patients after heart surgery. Resection of the hypertrophied septum allows normal left ventricular function. We describe two patients with subaortic stenosis and a complicated postoperative course following heart surgery and additional resection of the subaortic muscular stenosis. One patient was reoperated because of residual obstruction of the left ventricular outflow tract; the postoperative course was uneventful thereafter. The second patient died after the primary surgery because of low output syndrome and sepsis. The postoperative management of this group of patients is difficult, demanding frequent assessment of the patient's hemodynamic condition and echocardiographic surveillance.

摘要

间隔肥厚引起的动态性主动脉瓣下梗阻可能会使一些心脏手术后患者的血流动力学恶化。切除肥厚的间隔可使左心室功能恢复正常。我们描述了两名患有主动脉瓣下狭窄且心脏手术后病程复杂并需额外切除主动脉瓣下肌性狭窄的患者。一名患者因左心室流出道残余梗阻而接受再次手术;此后术后病程平稳。第二名患者在初次手术后因低心排血量综合征和败血症死亡。这类患者的术后管理困难,需要频繁评估患者的血流动力学状况并进行超声心动图监测。

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