左室室壁瘤分区术治疗缺血性心力衰竭并室壁瘤  

Ventricular Partitioning Device in Treating Ischemic Heart Failure with Left Ventricular Aneurysm

作　　者：李桂阳 王建 苏茂龙 王焱 

机构地区：[1]厦门市心血管病医院,厦门市361004

出　　处：《中国分子心脏病学杂志》2016年第3期1718-1720,共3页Molecular Cardiology of China

基　　金：厦门市科学技术局冠心病急症的远程诊断和区域协同救治平台二期(3502Z20151041)

摘　　要：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 Percutaneous implantation of a ventricular partitioning device for treatment of ischemic heart failure with left ventricular aneurysm. Methods Between January 2015 and May 2015, a total of 8 patients with myocardial infarction complicated left ventricular aneurysm were selected for implanting VPD （Ventricular Partitioning Device）. The surgery-related complications were found and treated in time. All these patients were followed up for a period of 6 months. Heart failure symptoms were evaluated using the NYHA class, functional exercise capacity was assessed through the six-minute walk test and LV ejection fraction was determined from Echocardiography before and 6 months after the operation. Results There are three possible complications associated with VPD surgery, including ventricular tachycardia, deteriorating renal function, lilac-femoral artery dissection. Our current data revealed no mortality and no morbidity. Post-procedure LV ejection fraction improved markedly compared to pre-procedure （43.4±7.9% vs 35.1±8.1%, P〈0.05）. Meanwhile, NYHA class reduced slightly （1.86±0.38 vs 2.86±0.38, P〈0.05 ） and Six-minute walk test increased evidently（414±102 vs 371±97m, P〈0.05）. Conclusions VPD is relatively safe and feasible. It can improve LV ejection fraction, the NYHA functional class and exercise tolerance for the patients of ischemic heart failure with left ventricular aneurysm.

关 键 词：左室室壁瘤分区术 缺血性心肌病 缺血性心力衰竭 室壁瘤 

分 类 号：R541.6[医药卫生—心血管疾病]