V. Popov, O. Bolshak, V. Boukarim, Olena V. Khoroshkovata, O. M. Gurtovenko
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引用次数: 1
摘要
案例描述。41岁男性患者F.被乌克兰国家医学科学院国立阿莫索夫心血管外科研究所收治为急性心脏病外科治疗科,诊断为扩张性心肌病。Mitral-tricuspid insufϐ角度。左心房黏液瘤。左心房肥大。肺动脉高压。患者手术时心衰竭症状为NYHA功能四级。经过一周的医学准备和附加检查,患者成功手术(切除左心房黏液瘤,在左右房室开口上施加支撑环,左心房环旁并发症)。术后无signiϐicant并发症。术后第12天,患者出院,病情满意。在偏远地区,患者在3年后突然死亡。结论。考虑到晚期心脏病患者初始病情严重,左室射血分数降低,左心房增大(7.8 cm),肺动脉高压(50 mm Hg)及合并症,左心复杂重建左心房和心室增大导致心肌功能状态及左心房和左心室射血分数形态学指标改善。
Case of Dilated Cardiomyopathy in Combination with Left Atrial Myxoma and Left Atriomegaly (Rare Clinical Case)
Case description. A 41-year-old male patient F. was admitted to the Department ofSurgical Treatment of Ac-quired Heart Diseases of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a diagnosis: Dilated cardiomyopathy. Mitral-tricuspid insufϐiciency. Left atrial myxoma. Left atriomegaly. Pulmonary hypertension. The patient was operated with heart failure symptoms of NYHA functional class IV.
After a week of medical preparation and additional examination,the patient was successfully operated on (remov-al of the left atrial myxoma, imposition of support rings on the left and right atrioventricular openings, paraanular plicacy of the left atrium). The postoperative period proceededwithout signiϐicant complications. On the 12th day after the operation, the patient was discharged in satisfactorycondition. In the remote period the patient died suddenly 3 years later.
Conclusion. Taking into account the initial serious condition of a patient with advanced heart disease with a reduced left ventricular ejection fraction, left atriomegaly (7.8 cm), pulmonary hypertension (50 mm Hg) and comorbidities, complex reconstruction of the left heart in atriomegaly and ventriculomegaly leads to an improvement in the functional state of the myocardium and morphometric indicators of left atrium and left ventricular ejection fraction.