心筋梗塞後心室中隔穿孔に関する実験的研究 : 血行動態並びにこれに対する薬物投与の効果について
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概要
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This experimental study was undertaken to clarify the homodynamic effects of the various drugs in an acute stage of ventricular septal rupture following acute myocardial infarction. Ventricular septal rupture was created in a total of 47 mongrel dogs using a specially designed perforator introduced through the right atrium and the tricuspid valve. There were good correlations with the hemodynamic deterioration and size of the ventricular septal rupture. When the diameter of the ventricular septal rupture was less than 9 mm, the hemodynamic changes were very little, and if the diameter was larger than 12 mm, prominent heart failure or shock were observed in most of the experimental dogs. Fluid-loading Dextran 40 was found to increase the pulmonary flow without increments of the systemic flow, indicating no therapeutic effect of volume-loading in these clinical settings. Hydralazine was effective in maintaining or increasing systemic flow with decrease in shunt flow in the dog with ventricular septal rupture. However, in the dog with ventricular septal rupture and acute myocardial infarction, combined use of dopamine and hydralazine was more effective in preventing hemodynamic deterioration. It is concluded that dopamine and or hydralazine are useful drugs for ventricular septal rupture following acute myocardial infarction, but medical treatment with these drugs have limitation in its effect that surgical closure seems to be imperative for the treatment of this disease.
- 神戸大学の論文