[通过右心室切开术双补片缝合室间隔穿孔后的巨大左心室动脉瘤]。

Q4 Medicine
Kuntae Ahn, Hiroyuki Hayashi, Nobuyuki Yoshitani, Hironobu Sugiyama, Takuya Misato, Taro Hayashi
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引用次数: 0

摘要

一名 66 岁的男子。他因左前降支闭塞导致心肌梗死,随后并发室间隔穿孔。通过右心室切口修补了室间隔穿孔,使用双补片进行闭合,并在补片之间注入胶水。术后早期疗效良好,但由于采用了右心室切开术,梗死的左心室前壁仍然存在。术后随访超声心动图显示左心室动脉瘤逐渐增大,成为巨大动脉瘤。由于出现呼吸窘迫等心衰症状,在首次手术穿孔 29 个月后,患者接受了左心室成形术。由于右心室切开术后左心室壁仍然较薄,因此应考虑到术后左心室动脉瘤的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Giant Left Ventricular Aneurysm After Double Patch Closure of Ventricular Septal Perforation Through Right Ventriculotomy].

A 66-year-old man. He had myocardial infarction due to occlusion of the left anterior descending branch, which was subsequently complicated by ventricular septal perforation. Ventricular septal perforation was repaired through right ventricle incision, applying double patches for closure, and injecting glue between the patches. The early postoperative course was good, but the infarcted left ventricular anterior wall remained because of the right ventriculotomy approach. A left ventricular aneurysm was demonstrated on postoperative follow-up echocardiography, which gradually enlarged to become giant. Since symptoms of heart failure such as respiratory distress appeared, left ventriculoplasty was performed 29 months after the perforation of the initial surgery. Since thinned left ventricular wall remains following right ventriculotomy approach, risk of postoperative left ventricular aneurysm should be taken into account.

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