Komeda M, David T E
Division of Cardiovascular Surgery, Toronto Hospital, Ontario, Canada.
J Thorac Cardiovasc Surg. 1993 Dec;106(6):1189-91.
Twelve patients underwent surgery for repair of false aneurysms of the left ventricle. The mean interval between the myocardial infarction and the diagnosis was 19 months (range 2 to 80 months). Congestive heart failure was the most common clinical presentation. Most patients had three-vessel coronary artery disease. The false aneurysm was posterior in 10 patients and anterior in two. Three patients with posterior aneurysm had severe mitral regurgitation. Repair was accomplished by resection of the false aneurysm and primary closure of the defect in four patients and by closure with a patch in eight. Nine patients also had coronary artery bypass. Mitral valve replacement was performed in three patients who had severe mitral regurgitation before the operation and in one patient who had severe mitral regurgitation after repair of the false aneurysm and could not be weaned from cardiopulmonary bypass. There were three operative deaths and one additional death after 2 months. All deaths occurred in patients who had mitral valve replacement. Eight patients survived the operation and remained well after a mean follow-up period of 62 months. Patients with false aneurysms of the left ventricle do well after surgical repair, except when concomitant mitral valve replacement is necessary.
12例患者接受了左心室假性动脉瘤修复手术。心肌梗死与诊断之间的平均间隔为19个月（范围2至80个月）。充血性心力衰竭是最常见的临床表现。大多数患者患有三支冠状动脉疾病。10例患者的假性动脉瘤位于后壁，2例位于前壁。3例后壁动脉瘤患者有严重二尖瓣反流。4例患者通过切除假性动脉瘤并直接缝合缺损完成修复，8例患者用补片缝合。9例患者还进行了冠状动脉搭桥术。3例术前有严重二尖瓣反流的患者以及1例在假性动脉瘤修复后出现严重二尖瓣反流且无法脱离体外循环的患者接受了二尖瓣置换术。有3例手术死亡，术后2个月又有1例死亡。所有死亡均发生在接受二尖瓣置换术的患者中。8例患者术后存活，平均随访62个月后情况良好。左心室假性动脉瘤患者手术修复后效果良好，除非需要同时进行二尖瓣置换术。
