心肌梗死后左心室后下动脉瘤。诊断和手术治疗]。

La Prensa medica mexicana Pub Date : 1979-11-01
S E Flores Covarrubias, C Acoltzin Vidal, G Nava Lopez, X Palacios Macedo
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引用次数: 0

摘要

这是一份关于在Cardiología y Neumología国立m西戈中心医院成功手术治疗左心室后段和下段动脉瘤的前四例病例的报告,占所有已实现的动脉瘤切除术的12%。患者均为男性,平均年龄57岁,既往有后下壁心肌梗死史,其中3例合并心绞痛和严重室性心律失常;胸部侧位X线示心脏廓影后下缘隆起;超声心动图显示二尖瓣以下心室直径增大;心室造影显示左心室后段和下段明显的舒张膨大和收缩扩张,无二尖瓣反流;选择性冠状动脉造影显示右侧占主导地位,近端闭塞100%。4例均行动脉瘤切除术,2例行冠状动脉旁路手术。所有病例均可见后内侧乳头肌,其中2例发现附壁血栓。
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[Postero'inferior aneurysm of the left ventricle following myocardial infarction. Diagnosis and surgical treatment].

This is a report of the first four cases of left ventricle aneurysm of the posterior and inferior segments successfully treated surgically in the Hospital de Cardiología y Neumología del Centro Médico Nacional, México D. F., and represent the twelve per cent of all realized aneurysmectomies. The patients were all men with 57 years mean age, and a previous history of posteroinferior myocardial infarction, complicated in three of them with angor and severe ventricle arrythmias; chest X ray in lateral view showed a bump of the posteroinferior border of the cardiac silhouette; the echocardiography increase in the ventricular diameter below the mitral valve; the ventriculography made evident a diastolic bulging with systolic expansion of posterior and inferior segments of the left ventricle and no mitral regurgitation; selective coronary arteriography showed a dominant right pattern with 100 per cent proximal occlusion. Aneurysmectomy was done in all four cases and aortocoronary by-pass in two. The posteromedial papilar muscle was found respected in all cases and in two cases a mural thrombus was detected.

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