左心室虚假动脉瘤在心室隔膜剖析关闭后:一个病例报告
Ryo Yamaguchi1, Satoshi Ohki2, Kiyomitsu Yasuhara2
1Department of Cardiovascular Surgery, Isesaki Municipal Hospital, Isesaki, Gunma, 372-0817, Japan. ryoyamaguchi0822@yahoo.co.jp.
General Thoracic and Cardiovascular Surgery Cases
|November 9, 2024
概括
心肌梗塞的一种罕见并发症,左心室伪假动脉瘤,需要在手术修复心室隔膜剖析期间安全关闭左心室入口,以防止复发.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗成像医学成像
背景情况:
- 左心室伪假动脉瘤是心肌梗塞后的罕见并发症,通常来自心脏内剖析性血瘤.
- 腹腔隔膜穿孔在左心室有一个入口,在右心室有一个出口.
研究的目的:
- 报告一个大左心室伪假动脉瘤的病例,该病例发生在心室隔膜解剖的手术修复后.
- 突出了手术修复期间左心室入口口安全关闭的重要性.
主要方法:
- 一名患有心室隔膜穿孔的72岁妇女通过右心室切口进行了初步三明治补丁修复.
- 手术后的成像显示出左心室的大型假动脉瘤,需要第二次手术.
- 第二次手术是用达克伦贴片通过伪虚动脉瘤关闭入口.
主要成果:
- 腹腔隔膜穿孔的初始手术修复并没有防止伪动脉瘤的形成.
- 手术后3个月出现了左心室的大型虚假动脉瘤,导致充血性心力衰竭.
- 在第二次手术中成功关闭左心室入口,从而解决了伪动脉瘤.
结论:
- 在心肌梗塞后治疗心室隔膜解剖时,左心室入口的安全关闭至关重要.
- 通过右心室切口修复三明治补丁需要对左心室入口口进行细致的注意.
- 建议使用带有大补丁的跨体床 sutures,以安全地关闭左心室入口口.
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