Sakamoto T, Ihashi K, Nakano H, Shimakura T, Ichikawa Y
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan.
Kyobu Geka. 1993 Jun;46(6):524-7.
The patient was a 72-year-old woman who was admitted with AMI. On the next day, a systolic murmur of Levine II/VI became audible on the left sternal border of the 5th intercostal space and VSP was diagnosed by the echocardiogram. The hemodynamics was comparatively stable, and so we scheduled the elective operation in the expectation of the healing of the infarction tissue. At the cardiac catheterization just before the operation, L-R shunt ratio was 64.9% and main PA was 41/18 (26) mmHg. Before the operation we marked the VSP position by Swan-Ganz catheter through the left ventricle and VSP closure and 2 CABG was performed. We concluded that this method was useful for the diagnosis and therapy of VSP.
该患者为一名72岁女性，因急性心肌梗死入院。次日，在第5肋间左胸骨缘可闻及Levine II/VI级收缩期杂音，经超声心动图诊断为室间隔穿孔（VSP）。血流动力学相对稳定，因此我们安排了择期手术，期望梗死组织愈合。在手术前的心脏导管检查中，左向右分流率为64.9%，主肺动脉压为41/18（26）mmHg。手术前，我们通过经左心室的Swan-Ganz导管标记了VSP的位置，然后进行了VSP封堵和2支冠状动脉旁路移植术（CABG）。我们得出结论，该方法对VSP的诊断和治疗有用。
