Tsukui H, Ohara K, Akimoto T, Mukaida M, Abe K
Department of Cardiovascular Surgery, St. Luke's International Hospital, Tokyo, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Sep;46(9):898-901. doi: 10.1007/BF03217841.
A 73-year-old woman with acute myocardial infarction (Seg. 6: 100%) was admitted to our hospital. She underwent percutaneous transluminal angioplasty (PTCA) and stent insertion to Seg. 6 on that day and anticoagulant therapy with urokinase and heparin was started in CCU. On the 4th day, chest pain developed suddenly and echocardiography revealed cardiac tamponade, so we suspected left ventricular free wall rupture. When blood pressure increased to 100 mmHg in the operating room, the left ventricular free wall rupture became "blow out" type. After establishing extracorporeal circulation, we glued Xenomedica and autologous pericardium using gelatin-resorcin-formaldehyde glue (GRF glue) to the linear tear without damaging the myocardium and coronary arteries and reducing left ventricular volume. Bleeding was completely controlled. This experience suggests that this procedure might be effective for left ventricular free wall rupture.
一名73岁急性心肌梗死（第6节段：100%）女性入住我院。当天她接受了经皮腔内血管成形术（PTCA）及第6节段支架置入术，并在冠心病监护病房开始使用尿激酶和肝素进行抗凝治疗。第4天，突然出现胸痛，超声心动图显示心包填塞，因此我们怀疑是左心室游离壁破裂。当手术室血压升至100 mmHg时，左心室游离壁破裂变成“爆裂”型。建立体外循环后，我们使用明胶-间苯二酚-甲醛胶（GRF胶）将Xenomedica和自体心包粘贴到线性撕裂处，未损伤心肌和冠状动脉，并减少了左心室容积。出血得到完全控制。这一经验表明，该手术可能对左心室游离壁破裂有效。
