巨大梗死后左心室后外侧动脉瘤,合并二尖瓣功能不全

N. M. Bikbova, M. Mazanov, M. A. Sagirov, N. I. Kharitonova, A. A. Baranov, I. A. Argir, I. R. Mingalimova, S. Y. Kambarov
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引用次数: 0

摘要

缺血性心脏病在心血管疾病的结构中占据主导地位。急性心肌梗死的早期再灌注治疗可降低死亡率和严重的冠状动脉疾病并发症。尽管冠状动脉疾病的治疗取得了进展,但20%的心脏病发作患者会出现左心室扩张和重塑,导致二尖瓣功能不全和左心室收缩功能障碍。左心室动脉瘤是心肌梗死的一种迟发性严重并发症,严重影响预后。大的左心室动脉瘤导致左心室进行性扩张,其容量超载,非梗死区壁张力增加,左心室功能特征下降,动脉瘤腔内血栓形成,危及生命的心律失常和猝死。梗死后左心室重构可导致继发性二尖瓣反流,这是长期死亡率的独立预测因子。冠心病及其并发症的外科治疗是现代心血管外科的主要问题之一。
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Giant postinfarction posterolateral left ventricular aneurysm, complicated by mitral insufficiency
Ischemic heart disease holds the leading position in the structure of cardiovascular diseases. Early reperfusion therapy for acute myocardial infarction led to a decrease in mortality and severe complications of coronary artery disease. Despite advances in the treatment of coronary artery disease, dilatation and remodeling of the left ventricle develop in 20% of patients who have had a heart attack, leading to mitral insufficiency and systolic dysfunction of the left ventricle. Aneurysm of the left ventricle is a delayed severe complication of myocardial infarction, which significantly worsens the prognosis. Large aneurysms of the left ventricle cause progressive dilatation of the left ventricle, its volumetric overload with an increase in wall tension in the non-infarction zone, decreased functional characteristics of the left ventricle, thrombosis in the aneurysm cavity, life-threatening arrhythmias, and sudden death. Postinfarction left ventricular remodeling can lead to secondary mitral regurgitation, which is an independent predictor of mortality in the longterm period. Surgical treatment of coronary heart disease and its complications is one of the main problems of modern cardiovascular surgery.
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