冠心病急性心梗并发室间隔穿孔的外科治疗

Surgical Treatment for Acute Myocardial Infarction Coronary Heart Disease Complicated with Ventricular Septal Perforation

目的评价急性心梗并发室间隔穿孔外科治疗的临床经验和手术效果.方法总结昆明医科大学附属延安医院心脏大血管外科自2010年6月至2011年8月期间冠心病急性心梗并发室间隔穿孔及室壁瘤4例病例资料,均行IABP辅助,同期行冠状动脉旁路移植、室间隔穿孔修补及室壁瘤切除、线性修补术.结果 4例患者均康复出院.术后左室射血分数(LVEF)较前提高,左室舒张末容积(LVDD)较前缩小,术前NYHA心功能Ⅲ~Ⅳ级,术后NYHA心功能Ⅰ~Ⅱ级,心功能较术前明显改善.结论冠心病急性心梗并发室间隔穿孔合理选择手术时机是取得良好治疗效果的重要因素.

Objective To evaluate the clinical experience in surgical and surgical results of acute myocardial infarction complicated with ventricular septal perforation. Methods The data of four cases for patients with acute myocardial infarction coronary heart disease complicated with ventricular septal perforation and room were summarized from June 2010 to August 2010. All patients underwent with a coronary artery bypass graft, ventricular septal perforation repair and repair of aneurysm resection,and linear neoplasty in the same period. Res ults Four cases were recovered and successfully discharged. Postoperative left ventricular ejection fraction(LVEF) was increased and left ventricular end-diastolic volume(LVDD) was narrowed after surgery. Preoperative and postoperative heart function NYHA class was Ⅲ-Ⅳ and Ⅰ-Ⅱ, respectively. Compared with preoperative, the postoperative heart function has improved significantly. Conclus ion It is an important factor to select the reasonable surgical timing in order to achieve good therapeutic effect for acute myocardial infarction coronary heart disease complicated with ventricular septal perforation.