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近三十年来,抑制神经内分泌系统的药物治疗在慢性心力衰竭似乎已难有突破性的进展,植入性器械治疗及外科手术治疗逐渐进入了心力衰竭的治疗领域,例如:植入型体内自动除颤器(ICD)、心脏再同步化治疗(CRT)和左室辅助装置及心脏移植等。上世纪90年代以来,外科医生就试图通过外科手术来阻止心肌梗死后左室重构的进展;但由于手术复杂、创伤较大、手术效果不确切,未能在临床上广泛开展。近年来出现的多种侵入性更小的植入性器械也进入临床试验阶段。本文将结合冠脉介入治疗后出现心力衰竭患者的发病机制及特点,结合近期的器械手段的进展,探讨伴左室心尖部室壁瘤的缺血性心力衰竭患者的治疗。
Nearly three decades, drug therapy that inhibits the neuroendocrine system appears to be difficult to make any breakthrough in chronic heart failure. Implantable devices and surgical treatments have gradually entered the treatment of heart failure, such as implantable in vivo auto Defibrillator (ICD), cardiac resynchronization therapy (CRT) and left ventricular assist devices and heart transplantation. Since the 90s of last century, surgeons tried to stop the progress of left ventricular remodeling after myocardial infarction by surgery. However, because of the complicated operation and large trauma, the effect of surgery is not exact enough and has not been widely applied clinically. In recent years, a variety of more invasive implantable devices also entered the clinical trial phase. This article will be combined with coronary heart disease in patients with heart failure and pathogenesis characteristics, combined with the progress of recent instruments, to explore with left ventricular apical aneurysm in patients with ischemic heart failure treatment.