Salati M, Di Biasi P, Pajè A, Cialfi A, Bozzi G, Santoli C
Division of Thoracic and Cardiovascular Surgery, L. Sacco Hospital, Milano, Italy.
Ann Thorac Surg. 1993 Aug;56(2):316-22. doi: 10.1016/0003-4975(93)91167-l.
From 1988 to 1991, 48 patients with left ventricular aneurysm underwent endoventriculoplasty with a circular patch to preserve the left ventricular geometry. Of these patients, 98% underwent concomitant myocardial revascularization, and in 77% the left anterior descending coronary artery was bypassed. The overall operative mortality rate was 4.1%. The 3-year survival rate was 91%, and 67% of patients had no further cardiac complications. Cardiac performance was assessed postoperatively by ventriculography in 28 patients. The global ejection fraction rose from 0.39 +/- 0.11 to 0.57 +/- 0.14 (p < 0.001); the left ventricular end-diastolic pressure fell from 20 +/- 7.5 mm Hg to 15 +/- 7.8 mm Hg (p < 0.05). Computerized analysis of regional contraction revealed a significant improvement in the anterolateral and apical segments and in the transitional zone. In 61% of the patients, a normal contraction pattern resumed, whereas in the remaining 39%, a residual deformity of the left ventricular chamber was present. The best results were obtained in patients with a preserved proximal septum at echocardiography.
1988年至1991年期间，48例左心室室壁瘤患者接受了使用环形补片的心室成形术以保留左心室形态。在这些患者中，98%同时接受了心肌血运重建，77%的患者旁路移植了左前降支冠状动脉。总体手术死亡率为4.1%。3年生存率为91%，67%的患者无进一步心脏并发症。术后通过心室造影对28例患者的心脏功能进行了评估。整体射血分数从0.39±0.11升至0.57±0.14（p<0.001）；左心室舒张末期压力从20±7.5mmHg降至15±7.8mmHg（p<0.05）。对局部收缩的计算机分析显示前外侧、心尖段及过渡区有显著改善。61%的患者恢复了正常收缩模式，而其余39%的患者左心室腔存在残余畸形。超声心动图显示近端室间隔完整的患者取得了最佳效果。
