“室间隔隧道心肌化学消融”治疗肥厚梗阻型心肌病临床疗效观察

目的探索经皮“室间隔隧道心肌化学消融术（PTSTMA）”治疗肥厚梗阻型心肌病（HOCM）的方法及疗效。方法观察PTMTMA和传统心肌化学消融术两种方法无水乙醇注入剂量、术后即刻静息左室流出道压力阶差（LVOTPG）下降程度、3个月心脏超声参数改变以及临床随访中主要临床症状的转归变化，比较两种方法的临床疗效。结果26例患者LVOTPG均下降≥50％；3个月心脏超声室间隔厚度、左房内径、压力阶差均较术前明显改善；随访胸痛、胸闷症状明显减轻，“室早”明显减少，心功能分级明显改善；两组无水乙醇注入量无明显差别，临床疗效也无差别。结论PTSTMA是HOCM心肌化学消融术的一种补充方法，近中期安全有效。

The clinical effect of percutaneous transluminal septal tunnel myocardial ablation on treating hypertrophic obstructive cardiomyopathy

Objective To search the methodology and therapeutic effect of percutaneous transluminal septal tunnel myocardial ablation （PTSTMA） on treating 26 cases with hypertrophic obstructive cardiomyopathy （HOCM）. Methods The volume of alcohol injected, the decrease degree of LVOTPG immediately post-operaT- tion, the variatiovt of cardiac ultrasound parameter at 3 months and main clinical syndrome alteration during follow up in PTSTMA and traditional myocardial ablation groups were compared, and then the clinical effect of PTSTMA was summarized. Results The left ventricular outflow tract pressure gradient （LVOTPG） of 26 HOCM patients re- duced ~〉 50%. Left atrium dimensions, interventricular septum thickness （IVS） and LVOTPG had remarkably im- proved than before the procedure by cardiac ultrasound at 3 months. The clinical symptoms such as chest pain, chest discomfort were significantly improved, the amount of ventricular premature beat was significantly decreased and the grades of cardiac function were also significantly raised than before the procedure. There were no signifi- cant differences about the volume of alcohol injected and clinical composite indexes in PTSTMA and traditional PTSMA. Conclusion The PTSTMA is a supplemental method of PTSMA on treating HOCM, which is safe and useful during the short term and metaphase.