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本文报告41例并发于陈旧性心肌梗塞的室性心动过速的手术治疗。其中37例先作了心外膜标测。1975年以前的14例主要施行心室动脉瘤切除或单纯心室切开术。术后近期死亡5例(36％),死因2例力心衰,1例为心动过速复发;远期死亡5例,死因一例为心动过速复发,一例猝死,2例为心衰,另一例力非心脏原因。1975年以后的27例施行环行心内膜性心室切开术。术后近期死亡4例(15％),死因2例为低心排出量,2例为非心脏原因;远期死亡5例,死因2例力心衰,2例力非心脏性原因,1例为心动过速复发。1975年以前手术病例,术后心动过速复发者占25％,因而引起死亡者占8％。1975年以后手术病例,术后心动过速复发者占24％,由此引起死亡者占4％。以上结果提示,环行心内膜性心室切开术的效果较过去应用于心室性心动过速的手术为佳。
This article reports 41 patients with concurrent myocardial infarction in the treatment of ventricular tachycardia surgery. 37 cases first made epicardium mapping. Prior to 1975, 14 patients underwent primary ventricular aneurysm resection or simple ventriculotomy. There were 5 cases (36%) of the immediate postoperative deaths, 2 cases of heart failure due to the cause of death, 1 case of recurrence of tachycardia, 5 cases of long-term death, one case of death due to recurrent tachycardia, one case of sudden death and 2 cases of heart failure. A case of non-cardiac causes. After 1975, 27 cases underwent endocardial ventricular ring incision. Four patients died of immediate cardiac output (15%). The cause of death was low cardiac output in 2 patients and noncardiac causes in 2 patients. There were 5 long-term deaths, 2 heart failure patients, 2 non-cardiac causes and 1 non-cardiac cause Tachycardia recurrence. Before 1975, surgical patients, recurrence of tachycardia accounted for 25%, resulting in 8% of those who died. After 1975 cases of surgery, recurrence of tachycardia accounted for 24%, resulting in 4% of deaths. The above results suggest that the effect of circumferential endocardial ventriculotomy is better than the previous application of ventricular tachycardia surgery.