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目的评估针对缺血性心力衰竭并室壁瘤植入左室分区器的安全性和疗效。方法在2015年1月至2015年5月纳入8例心肌梗死并室壁瘤患者,成功行经皮左室室壁瘤分区术治疗,观察和及时处理手术相关并发症。随访观察6个月。在术前和术后6个月,进行纽约心功能分级、测定6分钟步行试验及行超声心动图检查评估心功能。结果共三例可能手术相关发症,包括室速发作、肾功能恶化、右髂动脉-股动脉夹层,目前数据无致死和致残事件发生。术后6个月左室射血分数较术前显著升高(43.4±7.9%比35.1±8.1%,P<0.05),同时术后纽约心功能分级较术前下降(1.86±0.38比2.86±0.38,P<0.05),术后六分钟步行距离较术前明显升高(414±102 m比371±97m,P<0.05)。结论左室室壁瘤分区术是相对安全及可行的。其能改善缺血性心力衰竭并室壁瘤患者的左室射血分数、心功能分级和提高运动耐量。
Objective To evaluate the safety and efficacy of the left ventricular compartment for ischemic heart failure and aneurysm implantation. Methods From January 2015 to May 2015, 8 patients with myocardial infarction and aneurysm were enrolled and successfully treated with percutaneous left ventricular aneurysm. The operation-related complications were observed and treated in time. Follow-up observation of 6 months. Six months prior to and 6 months after surgery, NYHA function was assessed, 6-minute walking test and echocardiography were performed to evaluate cardiac function. Results A total of three possible surgery-related complications, including VT onset, worsening renal function, and right iliac artery-femoral artery dissection, were present with no fatal or disabling events. The left ventricular ejection fraction at 6 months after operation was significantly higher than that before operation (43.4 ± 7.9% vs 35.1 ± 8.1%, P <0.05), meanwhile the NYHA function score was significantly lower after operation (1.86 ± 0.38 vs 2.86 ± 0.38, P <0.05). The walking distance at six minutes after operation was significantly higher than that before operation (414 ± 102 m vs. 371 ± 97 m, P <0.05). Conclusion Divisional surgery of left ventricular aneurysm is relatively safe and feasible. It improves left ventricular ejection fraction, cardiac function, and exercise tolerance in patients with ischemic heart failure and aneurysm.