Pomini G, Lupia M, Milano A, Gribaldo R
Servizio di Riabilitazione Cardiologica, Ospedale di Padova.
G Ital Cardiol. 1993 Mar;23(3):289-93.
Two cases of left ventricular pseudoaneurysm following myocardial infarction are presented. In the first patient a two-dimensional echocardiography study revealed a small posterior echo-free space that appeared to communicate with the left ventricle through a small defect in the left ventricular posterior wall. Conventional Doppler echocardiography and colour flow imaging demonstrated flow between the left ventricle and the paraventricular chamber. In the other patient, the same study detected an enormous false aneurysm. We found a large extramyocardial echo-free space within the pericardial cavity. The site of this space was posterolateral and communicating with the left ventricular cavity. Cardiac catheterization and surgery confirmed the diagnosis. A postoperative echocardiographic study demonstrated a persistent but smaller saccular echo-free space and a residual shunt through one site of repair in the first patient; in the other, after surgical treatment there was no residual flow, but a left ventricular dysfunction was detected. Two dimensional and color Doppler echocardiography is the best technique among the noninvasive methods, for detecting and following up left ventricular pseudoaneurysms.
本文报告两例心肌梗死后左心室假性动脉瘤病例。第一例患者的二维超声心动图检查显示左心室后壁有一个小的无回声区，似乎通过左心室后壁的一个小缺损与左心室相通。传统的多普勒超声心动图和彩色血流成像显示左心室与室旁腔之间有血流。另一例患者，同样的检查发现一个巨大的假性动脉瘤。我们在心包腔内发现一个大的心肌外无回声区。该区域位于后外侧，与左心室腔相通。心导管检查和手术证实了诊断。术后超声心动图检查显示，第一例患者有一个持续存在但较小的囊状无回声区，且在一个修复部位有残余分流；另一例患者术后无残余血流，但检测到左心室功能障碍。二维和彩色多普勒超声心动图是检测和随访左心室假性动脉瘤的非侵入性方法中最佳的技术。
