21例心肌梗死后室间隔穿孔的外科治疗

Surgical treatment of myocardial infarction with ventricular septal perforation

目的:探讨心肌梗死(MI)后室间隔穿孔患者的外科治疗方法。方法:2003年11月至2011年10月,21例AMI后室间隔穿孔行外科手术治疗,本研究回顾性分析全组围术期及中长期生存状况,比较手术前后心功能评级、左心室射血分数(LVEF)和舒张期末内径(LVEDD)。结果:全组围术期死亡2例(2/21)。随访(36±13)个月,死亡3例,全组5年生存率为(76.8±13.5)%。全组患者手术前射血分数为(45.1±9.1)%,术后6个月随访期,射血分数为(51.3±4.3)%,P<0.05。结论:心肌梗死(MI)合并室间隔穿孔手术治疗,可以取得较满意的围术期和中长期效果,并显著提高左心室射血分数。

Objective：Our objective was to investigate the effect of surgical treatment of the myocardial infarction （MI） with ventricular septal perforation. Methods： from November,2003 to October, 2011,21 pa- tients of MI with ventricular septal perforation underwent surgical treatment at Anzhen hospital. The medical re- cords were retrospectively reviewd. Results： There were 2 （2/21） early deaths. With a mean follow-up of （36. 1±13.2） months, there were 3 late deaths, and the 5-year survival rate was （76. 8±13.5）%. the left ventricular ejection fration（LVEF） were（45.1±9. 1 ）% before the surgical treatment, and the LVEF half a year after the surgical treatment were （51.3±4. 3 ） %, P 〈 O. 05. Conclusion： the surgical treatment of the my- ocardial infarction with ventricular septal perforation could get a relatively satisfiable early and late survival rate, and the left ventricular ejection fraction could be promoted significantly through the surgical treatment to patients of MI with ventricular septal perforation.