Fusegawa Y, Abe S, Sakakibara M, Handa S
Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa.
Intern Med. 1999 Jul;38(7):585-9. doi: 10.2169/internalmedicine.38.585.
Non-surgical reduction of septal myocardial mass was performed with success in a 48-year-old male with hypertrophic obstructive cardiomyopathy. Angioplasty balloon inflated in the first septal branch of the left anterior descending artery dramatically reduced the pressure gradient across the outflow tract of the left ventricle. Following injections of absolute alcohol into the artery with the balloon kept inflated induced a small septal myocardial infarction. By hemodynamic evaluation, the peak pressure gradient of 108 mmHg before the procedure was decreased to 30 mmHg. Clinical improvement in New York Heart Association (NYHA) functional class was obtained. At 3-month follow-up, the patient was doing quite well; the gradient was only 10 mmHg at rest and 25 mmHg with Valsalva maneuver.
对一名48岁肥厚型梗阻性心肌病男性患者成功实施了非手术性室间隔心肌质量减少术。在左前降支的第一间隔支中充盈的血管成形术球囊显著降低了左心室流出道的压力梯度。在球囊保持充盈的情况下向该动脉注射无水酒精诱发了小面积的室间隔心肌梗死。通过血流动力学评估，术前108 mmHg的峰值压力梯度降至30 mmHg。纽约心脏协会（NYHA）心功能分级获得了临床改善。在3个月的随访中，患者情况良好；静息时梯度仅为10 mmHg，瓦尔萨尔瓦动作时为25 mmHg。
