Yamanaka J, Takeuchi Y, Gomi A, Nakatani H, Azuhata K, Namiki S
Department of Cardiovascular Surgery, Kanto Teishin Hospital, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Jan;44(1):58-62.
A 60-year-old diabetic women with acute inferior myocardial infarction was admitted to our hospital. An echocardiogram suggested a left ventricular false aneurysm. A left ventricular cineangiogram showed the communication between the left ventricle and the right ventricle through a false aneurysm. At operation one week after the infarction, the pericardial space was free from adhesions. A pseudo-false aneurysm communicating to both ventricle was revealed. The defects were closed with patches and pledgetted mattress sutures. The pseudo-false aneurysm was obliterated with pledgetted mattress and running sutures. The postoperative course was uneventful and the patient was discharged without complication. We emphasize the importance of preoperative morphological and hemodynamic evaluation using a left ventricular cineangiogram in the case of post-myocardial infarction ventricular septal perforation.
一名60岁患有急性下壁心肌梗死的糖尿病女性被收治入我院。超声心动图提示左心室假性动脉瘤。左心室造影显示左心室与右心室通过假性动脉瘤相通。在心肌梗死后一周进行手术时,心包腔无粘连。发现一个与两个心室相通的假性假性动脉瘤。缺损用补片和带垫片褥式缝线封闭。假性假性动脉瘤用带垫片褥式缝线和连续缝线闭塞。术后过程顺利,患者无并发症出院。我们强调在心肌梗死后室间隔穿孔病例中,术前使用左心室造影进行形态学和血流动力学评估的重要性。