外科治疗左心室室壁瘤不同术式的选择及疗效分析

目的:探讨左心室室壁瘤两种手术方式的疗效。方法:2004年3月至2012年9月,对45例冠心病合并室壁瘤手术治疗患者的临床资料进行分析,其中男性36例,女性9例;平均年龄(55.1±6.3)岁。均行冠状动脉旁路移植术,同期行线性缝合术21例,心内膜环缩成形术24例,二尖瓣成形术1例,二尖瓣置换术2例,血栓清除术12例。结果:术后左心室舒张末期内径较术前缩小;左心室射血分数较术前升高;差异均有统计学意义(P<0.05),围术期死亡2例,均死于严重低心排出量综合征(低心排)。38例术后随访3~6个月,随访率84%,心功能I~II级,近中期无死亡患者。结论:根据室壁瘤的大小和病变程度合理的选择手术方式、有效的心肌保护是手术成功的关键。

Clinical analysis of two types of surgical treatment of left ventricular aneurysm

Objective: To explore the efficacy of two surgical procedure on heart ventricle aneurysm.Methods: We summarized 45 cases coronary heart disease with ventricle aneurysm which include 36 males and9 females form 2004. 3 to 2012. 9,average age is( 55. 1 + 6. 3) years. All the patients have undergone the coronary artery bypass graft operation and concomitant procedure involving 21 cases of linear repairmen,24 cases of endoventriculoplasty,1 case of mitral valvoplasty,2 cases of mitral replacement,12 cases of thrombectomy.Results: Postoperative left ventricular end diastolic diameter decreases while left ventricle ejection fraction increases compared with the preoperative data and The difference is statistically significant( P < 0. 05). perioperative death in two cases due to severe low cardiac output syndrome. 38 cases were followed up for 3-6 months,follow-up rate is 84%,cardiac function was class I-II,no patient death during followed period. Conclusion:We should chose reasonable surgical approach According to the size and lesion extent of aneurysm,it is crucial event for success that take effective steps on myocardium protection.