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首页> 外文期刊>Journal of cardiac surgery. >Left ventricular free wall rupture: A real nightmare
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Left ventricular free wall rupture: A real nightmare

机译:左心室免费墙壁破裂:真正的梦魇

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Left ventricular free wall rupture (LVFWR) is a rarest but often lethal mechanical complication of acute myocardial infarction (AMI). The mortality rate for LVFWR is described from 75% to 90% and it is the cause for 20% of in-hospital deaths after AMI. Death results essentially from the limited time available for emergent intervention after onset of symptoms. Emergency surgery is indicated and normally the rupture site is easily identified, but it may not be apparent macroscopically, corresponding to transmyocardial or subepicardial dissection with an external rupture far from the infarction site, or already thrombosed and contained. Repair of the ventricular wall is usually achieved either by suturing the edges of the tear or closing it with patches of artificial material or biological tissues, usually using some kind of biological glue. However, several cases of successful conservative management have been described. In this Editorial, I comment on the metanalysis conducted by Matteucci et al, published in this issue of the Journal, including 11 nonrandomized studies and enrolling a total of 363 patients, which brings a great deal of new knowledge that can help not only in the prevention but also in the management of this dreadful complication of AMI.
机译:左心室游离壁破裂(LVFWR)是急性心肌梗死(AMI)最罕见但通常致命的机械性并发症。LVFWR的死亡率在75%到90%之间,是AMI后20%住院死亡的原因。死亡主要是由于症状出现后可用于紧急干预的时间有限。需要急诊手术,通常很容易确定破裂部位,但在宏观上可能不明显,对应于经心肌或心外膜下剥离,外部破裂远离梗死部位,或已血栓形成并被控制。心室壁的修复通常是通过缝合撕裂的边缘或用人工材料或生物组织修补,通常使用某种生物胶。然而,已经描述了几个成功的保守管理案例。在这篇社论中,我对Matteucci等人在本期杂志上发表的荟萃分析进行了评论,包括11项非随机研究,共纳入363名患者,这带来了大量新知识,不仅有助于AMI的预防,也有助于AMI这一可怕并发症的处理。

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