关键词: 体外循环, 室颤, 室壁瘤, 冠状动脉搭桥

Abstract:

Objective To study the clinical result of ventricular endo-aneurysmorrhaphy and left ventricle reconstruction under ventricular fibrillation (VF) on hypothermia cardiopulmonary bypass. Methods Operations were performed in 14cases of ventricular aneurysm (male 12, female 2). Age range 51～75 average (63±7). NYHA Ⅳ5 cases, Ⅲ6 cases, Ⅱ2 cases, Ⅰ1 case, LVEF 10%～50%, (32±11)%. Myocardial infarction in 14 cases. 1 case was performed by direct felt strips suture under ventricular fibrillation on hypothermia cardiopulmonary bypass. 9 cases were done by endo-aneurysmorrhaphy using felt patch plus outside sandwich left ventricle reconstruction in the same way, including 3cases with thrombus removal, and 1 case with mitral valve repair. 4 cases were performed by endo-aneurysmorrhaphy using inside per-string suture plus outside sandwich left ventricle reconstruction by the same myocardial protection method, including 1case with ventricle septal perforation repair. Results Mortality of this study was zero. CPBtime was 43～168 min, (97±39) min, Ventilation time was 8～50 h, (21±14) h, 6 cases were supported by IABP. No graft for 1 case, one graft with 1 case, two grafts with 5 cases, three grafts with 5 cases, four grafts in 1 case, totally three LIMA grafts, two RAgrafts and 25 vein grafts were used in this study. One case was reopened for bleeding. Conclusion The procedure of ventricular endo-aneurysmorrhaphy under ventricular fibrillation on hypothermia cardiopulmonary bypass is safe. The result of myocardium protection of hypothermia ventricular fibrillation is satisfactory.

Key words: cardiopulmonary bypass, ventricular fibrillation, ventricular aneurysm, coronary artery bypass