Pillière R, Gerardin B, Petitier H, Hue S, Raymond P, N'Guyen A, Dubourg O
Clinique Ambroise Paré, 27, bd Victor Hugo, 92200 Neuilly-sur-Seine.
Arch Mal Coeur Vaiss. 2002 Mar;95(3):213-7.
We report here the long term follow-up of the first french case, at our knowledge, of alcohol septal transcoronary ablation in March 1998 in Clinique Ambroise Paré in an 76 year-old woman. This patient was in NYHA III-IV functional class and at control outflow gradient was 100 mmHg. She was prior treated with high dosis of beta-blockers then DDD-pacemaker with no effects on symptoms. The technique used was the one described by Sigwart and al., with injection of 3 cm3 of ethyl alcohol in the first septal branch, after checking decrease of gradient during occlusion of septal branche with balloon angioplasty. After alcohol ablation, the gradient decreased immediately to 15 mmHg and disappeared at long-term follow up. Three years and half after the procedure, no complication occurred, the patient remains asymptomatic and the control echocardiography shows interventricular septal reduction of thickness from 22 to 12 mm.
据我们所知,我们在此报告法国首例经冠状动脉酒精间隔消融术的长期随访情况。该病例于1998年3月在安布罗斯·帕雷诊所进行,患者为一名76岁女性。该患者处于纽约心脏协会(NYHA)心功能III - IV级,静息时流出道压差为100 mmHg。她此前接受过高剂量β受体阻滞剂治疗,后植入DDD起搏器,但症状均无改善。所采用的技术是西格瓦特等人描述的方法,在用球囊血管成形术阻断间隔支时,确认压差降低后,在第一间隔支注入3立方厘米乙醇。酒精消融术后,压差立即降至15 mmHg,并在长期随访中消失。术后三年半,未出现并发症,患者仍无症状,超声心动图检查显示室间隔厚度从22毫米减至12毫米。