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室间隔穿孔是急性心肌梗死少见的并发症,却会迅速发生心力衰竭、心源性休克等并发症,预后极差。外科手术治疗是改善预后的根本措施,而手术时机的选择至关重要。其基本指导原则为:部分心肌梗死患者发生室间隔穿孔后会迅速出现双心室功能衰竭和/或心源性休克,经药物等保守治疗循环功能不能维持,又不能耐受外科手术,将会很快死亡,病死率很高;对该类已经失去了手术机会的患者,不宜施行手术治疗;对少数穿孔较小、能平稳控制病情的患者,严格把握手术指征后可给予药物和保守治疗1～4周后再行手术治疗,一旦无法确保病情稳定时,应及时改为急诊手术治疗;其余患者无论处于何种状态,均应立即行外科手术治疗。
Ventricular septal perforation is a rare complication of acute myocardial infarction, but rapid failure of heart failure, cardiogenic shock and other complications, the prognosis is poor. Surgical treatment is the fundamental measure to improve the prognosis, and the timing of the operation is crucial. The basic guiding principle is: some patients with myocardial infarction after ventricular septal perforation will rapidly appear biventricular failure and / or cardiogenic shock, the conservative treatment of drugs and other circulatory function can not be maintained, and can not tolerate surgery, will be very Fast death, high mortality; for such patients have lost the opportunity to surgery, should not be implemented surgery; for a small number of small perforation can be a smooth control of the disease in patients with strict surgical indications can be given drugs and conservative treatment 1 ~ 4 weeks after surgical treatment, once the disease can not be stable, should be promptly replaced by emergency surgery; the rest of the patients no matter what the state should be immediately underwent surgical treatment.