经皮室间隔化学消融术治疗肥厚梗阻型心肌病

目的评价室间隔化学消融术治疗肥厚梗阻型心肌病在急性期的效果。方法对52例确诊肥厚梗阻型心肌病患者进行经皮室间隔化学消融术治疗,并于术前、术后急性期进行超声心动观察。结果41例患者介入治疗成功,成功率为78.8%。术前超声观察室间隔平均厚度(22.96±5.15)mm,左室流出道压力阶差(LVOTPG)(92.64±38.69)mm Hg(1mm Hg=0.133kPa),术后急性期(4.8±3.2)d,室间隔平均厚度(21.27±4.64)mm,较术前比变薄,P<0.05;LVOTPG(51.79±38.99)mm Hg,较术前明显降低,P<0.001。结论经皮室间隔化学消融术治疗肥厚梗阻型心肌病,在急性期可使室间隔平均厚度降低,收缩期左室流出道压力阶差显著下降。

Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy

OBJECTIVE: Gauging the acute effect of Percutaneous transluminal septal myocardial ablation (PTSMA) as a treatment for hypertrophic obstructive cardiomyopathy (HOCM). METHODS: PTSMA was performed in 52 patients with symptomatic HOCM [mean age (44.7 +/- 11.9), male 38, female 14]. All patients had echocardiography performed prior to the procedure, 3-7 days post-PTSMA. RESULTS: Procedure success was achieved in 41 patients, success rate was 78.8%. The average left ventricular outflow tract (LVOT) gradient was (92.64 +/- 38.69) mm Hg before the procedure, and (51.79 +/- 38.99) mm Hg after the procedure (P < 0.001). The thickness of interventricular septum (IVS) was (22.96 +/- 5.15) mm before the procedure and became (21.27 +/- 4.64) mm 3-7 days post-PTSMA (P < 0.05). The incidence of right bundle branch block development post-PTSMA was 15.38% (> 48 h), and one patient (1.92%) had complete heart block. Two patients died. CONCLUSION: PTSMA is an effective non-surgical procedure for symptomatic patients with HOCM because of its low risk and its significant hemodynamic and echocardiographic improvement.