Kết quả sớm điều trị phẫu thuật 20 trường hợp thủng vách liên thất sau nhồi máu cơ tim cấp bằng phương pháp "bánh kẹp rộng" qua đường mở thất phải

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Tác giả: Đức Linh Hà, Quang Thiện Lê, Đăng Hùng Nguyễn, Hoàng Hà Nguyễn, Sinh Hiền Nguyễn, Thái Minh Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại: 611.124 Human anatomy, cytology, histology

Thông tin xuất bản: Phẫu thuật Tim mạch và Lồng ngực Việt Nam, 2021

Mô tả vật lý: 150-157

Bộ sưu tập: Metadata

ID: 498134

Thêm vào giỏ

20 consecutive patients (10 women and 10 men) with postinfarction ventricular septal rupture (mean age 72 years, range 48-84) underwent surgical repair for by extended sandwich technique performed through right ventricle from December 2018 to August 2021 in our institute. Reconstruction of the septum was performed by two patches according to the method described by Asai et al. The mean aortic clamp time was 101. The mean extracorporeal circulation time was 143 min. Postoperative intensive care unit (ICU) stay averaged 4 days (range, 1-10 days). There was 30% hospital mortality. 10% postoperative residual shunting was detected, and no patient needed reoperation for bleeding. Conclusion: This method of extended sandwich technique through right ventricle was safe, simple, and it could be performed in acute phase of myocardial infarction.Mô tả 20 trường hợp thủng vách liên thất sau nhồi máu cơ tim sử dụng phương pháp "bánh kẹp rộng" qua đường mở thất phải từ tháng 12 năm 2018 đến tháng 8 năm 2021. Kết quả: Tuổi trung bình 72,2 (48-84 tuổi), 50% là nam giới, thời gian từ khi khởi phát NMCT đến khi mổ là 4,7 ngày (sớm nhất 2 ngày, muộn nhất 11 ngày), 17 trường hợp thủng ở vị trí trước vách, 3 trường hợp thủng ở sau vách. Thời gian liệt tim trung bình 101 phút, thời gian chạy tuần hoàn ngoài cơ thể trung bình 143 phút, thời gian thở máy và thời gian điều trị sau mổ trung bình lần lượt là 4 ngày (sớm nhất là 1 ngày, muộn nhất là 10 ngày) và 14 ngày. Có 2 ca tồn lưu thủng vách sau mổ, 6 ca tử vong sau mổ, không có ca nào chảy máu phải mổ lại. Kết luận: Phương pháp "bánh kẹp rộng" điều trị thủng vách sau nhồi máu cơ tim cấp cho kết quả khả quan, có thể tiến hành mổ trong giai đoạn sớm sau nhồi máu.

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