Surgical Treatment of a Giant Postero-Inferior Left Ventricular Pseudoaneurysm Causing Severe Mitral Insufficiency and Congestive Heart Failure
スポンサーリンク
概要
- 論文の詳細を見る
Introduction: Left ventricular pseudoaneurysm caused by a transmural myocardial infarction is a fatal complication. Reliable diagnosis and on-time surgical intervention are significant for the patient’s survival.Methods/Results: A 70-year-old diabetic man with a two-month earlier history of successful stent implantation on the proximal right coronary artery because of total occlusion was admitted to our institution with symptoms of congestive heart failure. Transthoracic echocardiogram showed severely decreased overall LV systolic function and a large aneurismal sac attached to the inferior surface of the left ventricle, moderate tricuspid regurgitation and severe mitral insufficiency. On transesophageal echocardiography examination and cardiac magnetic resonance imaging, the aneurismal cavity appeared to be entirely surrounded by thrombi. During the operation, a left ventricular postero-inferior pseudoaneurysm was observed to extend to the mitral annulus. Purse string suturing was used to reduce left ventricular volume, and the hole was closed with a Dacron patch. The patient was weaned from the CPB without any difficulty. The patient’s postoperative period was uneventful, and his physical condition appeared to be very healthy (NYHA class I-II) after the first year.Conclusion: Following a myocardial infarction, a careful preoperative examination and proper way to diagnose are essential on patients with nonspecific complains or asymptomatic. Despite the risk of high mortality, patients may survive when they are diagnosed and undergo surgery at the right time.
論文 | ランダム
- 地域診療外来の新設と一年間の活動実績
- Bacillus thuringiensisの産生する殺虫性毒素タンパク質の腹水ガン細胞ならびにカイコ中腸細胞におよぼす作用
- 三輪壽雪の鬼萩茶碗 (特集2 萩焼の造形美 人間国宝 三輪壽雪の世界)
- 医療倫理とジャーナリズムの視点--生命の"いま"を報じてきた半世紀 (生命倫理へのアプローチ)
- 第25回紙面審査全国懇談会--脳死,臓器移植などの"生命報道"をめぐって〔含 討議〕