梗阻性肥厚型心肌病患者经皮腔内室间隔心肌消融术中的心腔内超声心动图引导

Intracardiac echocardiography guidance during percutaneous transluminal septal myocardial ablation in patients with obstructive hypertrophic cardiomyopathy.

作者信息

Pedone Chiara, Vijayakumar Maniyal, Ligthart Jourgen M L, Valgimigli Marco, Biagini Elena, De Jong Nico, Serruys Patrick W, Ten Cate Folkert J

机构信息

Bellaria Hospital, Cardiology Department, Bologna, Italy.

出版信息

Int J Cardiovasc Intervent. 2005;7(3):134-7. doi: 10.1080/14628840500280575.

DOI:10.1080/14628840500280575

PMID:16243734

Abstract

BACKGROUND

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.

METHODS AND RESULTS

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).

CONCLUSIONS

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.

摘要

背景

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。

方法与结果

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）。