Rigopoulos Angelos G, Seggewiss Hubert
Medizinische Klinik 1, Leopoldina Krankenhaus Schweinfurt, Gustav-Adolf-Str. 8, 97422 Schweinfurt, Germany.
Curr Cardiol Rev. 2016;12(4):285-296. doi: 10.2174/1573403x11666150107160344.
Hypertrophic obstructive cardiomyopathy is the most common genetic cardiac disease and is generally characterised by asymmetric septal hypertrophy and intraventricular obstruction. Patients with severe obstruction and significant symptoms that persist despite optimal medical treatment are candidates for an invasive septal reduction therapy. Twenty years after its introduction, percutaneous transluminal alcohol septal ablation has been increasingly preferred for septal reduction in patients with drug refractory hypertrophic obstructive cardiomyopathy. Myocardial contrast echocardiography and injection of reduced alcohol volumes have increased safety, while efficacy is comparable to the surgical alternative, septal myectomy, which has for decades been regarded as the 'gold standard' treatment. Data on medium- and long-term survival show improved prognosis with survival being similar to the general population. Current guidelines have supported its use by experienced operators in centres specialised in the treatment of patients with hypertrophic obstructive cardiomyopathy.
肥厚型梗阻性心肌病是最常见的遗传性心脏病，通常表现为不对称性室间隔肥厚和心室内梗阻。尽管接受了最佳药物治疗，但仍有严重梗阻和明显症状的患者是侵入性室间隔减容治疗的候选者。经皮腔内酒精室间隔消融术在引入20年后，越来越多地被用于药物难治性肥厚型梗阻性心肌病患者的室间隔减容治疗。心肌对比超声心动图和减少酒精用量的注射提高了安全性，而疗效与手术替代方法——室间隔心肌切除术相当，几十年来室间隔心肌切除术一直被视为“金标准”治疗方法。中长期生存数据显示预后有所改善，生存率与普通人群相似。当前指南支持经验丰富的操作者在专门治疗肥厚型梗阻性心肌病患者的中心使用该方法。
