[经皮腔内室间隔心肌消融术治疗肥厚性梗阻性心肌病]

[Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy].

作者信息

Qiao Shu-bin, Gao Run-lin, You Shi-jie, Yuan Jian-song, Chen Ji-lin, Yang Yue-jin

机构信息

Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100037, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2006 Mar;45(3):210-2.

PMID:16624154

Abstract

OBJECTIVE

Gauging the acute effect of Percutaneous transluminal septal myocardial ablation (PTSMA) as a treatment for hypertrophic obstructive cardiomyopathy (HOCM).

METHODS

PTSMA was performed in 52 patients with symptomatic HOCM [mean age (44.7 +/- 11.9), male 38, female 14]. All patients had echocardiography performed prior to the procedure, 3-7 days post-PTSMA.

RESULTS

Procedure success was achieved in 41 patients, success rate was 78.8%. The average left ventricular outflow tract (LVOT) gradient was (92.64 +/- 38.69) mm Hg before the procedure, and (51.79 +/- 38.99) mm Hg after the procedure (P < 0.001). The thickness of interventricular septum (IVS) was (22.96 +/- 5.15) mm before the procedure and became (21.27 +/- 4.64) mm 3-7 days post-PTSMA (P < 0.05). The incidence of right bundle branch block development post-PTSMA was 15.38% (> 48 h), and one patient (1.92%) had complete heart block. Two patients died.

CONCLUSION

PTSMA is an effective non-surgical procedure for symptomatic patients with HOCM because of its low risk and its significant hemodynamic and echocardiographic improvement.

摘要

目的

评估经皮腔内室间隔心肌消融术（PTSMA）治疗肥厚型梗阻性心肌病（HOCM）的急性效果。

方法

对52例有症状的HOCM患者[平均年龄（44.7±11.9）岁，男性38例，女性14例]实施PTSMA。所有患者在术前、PTSMA术后3 - 7天均接受了超声心动图检查。

结果

41例患者手术成功，成功率为78.8%。术前平均左心室流出道（LVOT）压差为（92.64±38.69）mmHg，术后为（51.79±38.99）mmHg（P<0.001）。术前室间隔（IVS）厚度为（22.96±5.15）mm，PTSMA术后3 - 7天变为（21.27±4.64）mm（P<0.05）。PTSMA术后右束支传导阻滞发生率为15.38%（>48小时），1例患者（1.92%）发生完全性心脏传导阻滞。2例患者死亡。