Longo E A, Cohen L S
Am Heart J. 1976 Jul;92(1):81-5. doi: 10.1016/s0002-8703(76)80407-3.
Three cases of rupture of the interventricular septum occurring coincident with acute inferior myocardial infarction are reported and the relevant literature is reviewed. One patient under-went successful surgical repair and, in addition, had an aneurysmectomy. Clues and pitfalls in diagnosis as well as the possible confusion with ruptured papillary muscle are discussed. Due to a dual blood supply to the interventricular septum, rupture occurs most often in the setting of advanced, diffuse coronary artery disease. Hypertension or other factors may be of lesser importance. Early surgical approach is advocated and may of necessity include infarctectomy, aneurysmectomy, and coronary artery by-pass surgery in addition ot repair of the ruptured interventricular septum. Use of an intraaortic balloon counterpulsator may prove to be of considerable help in the preoperative and postoperative management of these patients.
本文报告了3例与急性下壁心肌梗死同时发生的室间隔破裂病例，并对相关文献进行了综述。1例患者成功接受了手术修复，此外还进行了动脉瘤切除术。文中讨论了诊断的线索和陷阱，以及与乳头肌破裂可能存在的混淆。由于室间隔有双重血液供应，破裂最常发生在晚期弥漫性冠状动脉疾病的情况下。高血压或其他因素可能不太重要。提倡早期手术治疗，除了修复破裂的室间隔外，可能还需要进行梗死切除术、动脉瘤切除术和冠状动脉搭桥手术。使用主动脉内球囊反搏器可能对这些患者的术前和术后管理有很大帮助。
