Pedone Chiara, Vijayakumar Maniyal, Ligthart Jourgen M L, Valgimigli Marco, Biagini Elena, De Jong Nico, Serruys Patrick W, Ten Cate Folkert J
Bellaria Hospital, Cardiology Department, Bologna, Italy.
Int J Cardiovasc Intervent. 2005;7(3):134-7. doi: 10.1080/14628840500280575.
Percutaneous transluminal septal myocardial ablation (PTSMA) recently emerged as an alternative to myectomy for hypertrophic obstructive cardiomyopathy (HOCM) patients with drug-refractory symptoms. The target septal branch selection is a main point to achieve the therapeutic result.
We report about PTSMA performed using intracardiac echocardiography (ICE) to guide the procedure in 9 symptomatic HOCM patients. The target septal branch was chosen on the basis of the risk-area visualized using ICE after injection of a contrast agent. During alcohol administration a backscattered signal enhancement of the infarcted area was detected. The procedures were uncomplicated and effective to reduce the gradient from 78.9+/-20.4 mmHg to 7.8+/-7.9 mmHg (p<0.0001).
In this initial experience ICE monitoring during PTSMA was safe and provided high quality and continuous imaging of the treated segment of the septum during the whole procedure.
经皮腔内室间隔心肌消融术（PTSMA）最近成为药物难治性症状的肥厚性梗阻性心肌病（HOCM）患者心肌切除术的替代方法。目标间隔支的选择是实现治疗效果的关键。
我们报告了在9例有症状的HOCM患者中使用心腔内超声心动图（ICE）引导进行PTSMA的情况。在注射造影剂后，根据ICE显示的风险区域选择目标间隔支。在注入酒精期间，检测到梗死区域的背向散射信号增强。手术过程顺利，有效将压差从78.9±20.4 mmHg降至7.8±7.9 mmHg（p<0.0001）。
在这一初步经验中，PTSMA期间的ICE监测是安全的，并在整个手术过程中提供了高质量的、连续的室间隔治疗节段成像。
