60例梗阻性肥厚型心肌病化学消融治疗近期及中期疗效观察

目的探讨经皮室间隔心肌消融术(PTSMA)治疗梗阻性肥厚型心肌病(HOCM)方法及疗效.方法回顾分析采用心脏超声声学造影(MCE)介导下行PTSMA治疗的60例HOCM患者术后近期及中期的随访资料.结果60例患者中54例术后左室流出道压差(静息和激发)较术前下降》50%,6例下降》30%但《50%,PTSMA成功率100%;术后随访2周～6年,平均2.5年,56例患者临床症状明显改善或消失,3例症状复发,1例术后1年死于扩张型心肌病并发心力衰竭.无一例需安装永久心脏起搏器.结论PTSMA治疗HOCM近期及中期疗效显著、安全.

Percutaneous translum inal septal myocardial ablation in 60 patients with hypertrophic obstructive cardiomyopathy:immediate and followup results

Objective:To investigate the effects of percutaneous transluminal septal myocardial ablation(PTSMA)in patients with hypertrophic obstructive cardiomyopathy(HOCM).Method:A retrospective study on 60 patients with HOCM underwent PTSMA with application of myocardial contrast echocardiography(MCE).Result:The rest and provoked left ventricular outflow tract pressure gradient monitored by catheter was reduced more than 50% compared with the preoperation level in 54 casea,reduced more than 30% but less than 50% in 6 cases.After following up 2 weeks 6 years,56 cases had no or less clinical symptoms,3 cases recurred and one case died from dilated congestive cardiomyopathy at 18 monthes after PTSMA.No patient required permanent pacemaker.Conclusion:PTSMA was an effective and safe treatment for patients with HOCM.