Pernod J, Servelle M, Hardel P, Louis P, Haguenauer G, Kermarec J, Duret J C
Ann Med Interne (Paris). 1977 Oct;128(10):733-8.
Previously fatal in the majority of cases, traumatic interventricular communications are now curable by surgery. This is illustrated by the case described here of a 20 year old man. 62 other cases were found in the literature. A systolic murmur is the essential feature in diagnosis but it may be discovered some time after the accident. The demonstration of cardiomegaly has less diagnostic significance than ECG signs suggestive of an infarction. Haemodynamic studies are essential to confirm the diagnosis and to provide an accurate assessment of the lesion. The spontaneous course is serious since death results in two thirds of cases. Surgery is indicated, other than in well tolerated forms with a minimal shunt. The approach used has almost always been right cardiotomy. However, incision of the left ventricle offers better visibility of the lesions which may be masked by the papillary muscles when a right-sided approach is adopted. This was used in the present case with an excellent result since the patient was able to continue the military career for which he had opted.
外伤性心室交通在大多数情况下以前是致命的，现在可通过手术治愈。本文所述一名20岁男子的病例说明了这一点。文献中还发现了其他62例病例。收缩期杂音是诊断的主要特征，但可能在事故发生一段时间后才被发现。心脏扩大的表现比提示梗死的心电图征象的诊断意义小。血流动力学研究对于确诊和准确评估病变至关重要。其自然病程严重，因为三分之二的病例会导致死亡。除了分流极小且耐受性良好的情况外，均需进行手术。几乎总是采用右心切开术。然而，切开左心室能更好地观察病变，而采用右侧入路时病变可能被乳头肌掩盖。本病例采用了这种方法，效果极佳，因为患者能够继续他所选择的军事生涯。
