冠状动脉搭桥术同期行左心室室壁瘤切除术的疗效分析

Clinical Analysis of Surgical Ventricular Restoration for Left Ventricular Aneurysm Combined with Coronary Artery Bypass Grafting

目的:探讨冠状动脉搭桥术同期行左心室室壁瘤(LVA)切除术的外科治疗疗效。方法:统计我院2002-01至2007-12因冠心病合并LVA行外科手术治疗的39例患者资料。左心室成形术方法分为两种:梭形切除、线形缝合法和心内膜环缩成形术,旷置梗死的心肌组织,再缝合环缩后的切口。结果:手术无死亡病例,同术前比较,左心室舒张末期内径明显减小,左心室收缩功能提高。结论:外科手术治疗LVA是有效的方法,两种室壁瘤的成形术式均可使患者的左心室形态功能得到改善,根据患者室壁瘤的病变程度合理选择适当的手术方式是手术成功的重要保障。

Objective： To analyze the operative effect of left ventricular aneurysm （LVA） restoration combined with coronary, artery bypass graft （CABG）. Methods ： A total of 39 patients who underwent LVA restoration with CABG from January 2002 to December 2007 in our hospital were studied,there were 17 patients used linear repair technique, and 21 with endocardium encircle suturing remodeling. Transthoracic echocardiography and/or transesophageal echocardiography were performed peri-operatively; left ventricle ejection fraction （LVEF） and left ventricle end-diastohc volume （LVEDV） were recorded. Results ： No patient died during hospitalization. The echocardiography showed that ＇all patients＇ LVEF were increased, while LVEDV were decreased post-operatively ,follow up study indicated that the heart function was improved in all patients. Conclusion： Surgical LVA restoration combined with CABG was an effective approach for patients with left ventricular aneurysm.