Dante Pazzanese Heart Institute, São Paulo, Brazil.
Dante Pazzanese Heart Institute, São Paulo, Brazil.
Ann Thorac Surg. 2021 Oct;112(4):e279-e281. doi: 10.1016/j.athoracsur.2021.01.029. Epub 2021 Jan 30.
This report describes the case of a 64-year-old woman with a previous diagnosis of obstructive hypertrophic cardiomyopathy who underwent surgical myectomy but who had a persistent midventricular residual gradient. The patient was symptomatic despite medical treatment and chose to undergo percutaneous radiofrequency (RF) ablation focused on the gradient. RF delivery was performed, and the gradient was reduced from the initial 105/68 mm Hg (during Valsalva maneuver/at rest before ablation) to 24/10 mm Hg. This reduction was sustained for the next 12 months. Percutaneous RF ablation may be a reasonable option for second surgical myectomy, and the protocol can be easily reproduced.
本报告描述了一位 64 岁女性的病例，她此前被诊断为梗阻性肥厚型心肌病，并接受了外科心肌切除术，但仍存在中室间隔残留梯度。尽管经过药物治疗，患者仍有症状，并选择接受针对梯度的经皮射频 (RF) 消融。进行了 RF 输送，梯度从初始的 105/68mmHg（在消融前的瓦尔萨尔瓦动作/休息期间）降低至 24/10mmHg。这种降低在接下来的 12 个月中持续存在。对于第二次外科心肌切除术，经皮 RF 消融可能是一种合理的选择，并且该方案可以很容易地复制。
