Gaer J A, Gordon L, Wharton J, Polak J M, Taylor K M, McKenna W, Parker D J
Royal Postgraduate Medical School, Hammersmith Hospital, Department of Cardiothoracic Surgery, London.
Br Heart J. 1993 Dec;70(6):574-7. doi: 10.1136/hrt.70.6.574.
A novel method of cardiac denervation by cryoablation has been developed experimentally. The technique uses liquid nitrogen delivered under pressure to ablate the principal sources of cardiac innervation--namely, the adventitia surrounding the aorta, pulmonary arteries, and veins. The technique has been verified experimentally both in vivo by physiological means and in vitro by quantitative immunohistochemistry and the measurement of myocardial noradrenaline concentrations. A 35 year old woman presented with intractable precordial pain, normal epicardial coronary arteries, and hypertrophic cardiomyopathy. Her symptoms were refractory to maximal medical treatment and she was thought to be unsuitable for either conventional myocardial revascularisation, autotransplantation, or allografting with the concomitant risk of transplant coronary artery disease. She therefore underwent cardiac denervation by the method developed in the laboratory. There was quantitative immunohistochemical evidence of extrinsic cardiac denervation associated with a considerable improvement in her symptoms. This improvement persisted during a follow up period of over 16 months.
一种通过冷冻消融进行心脏去神经支配的新方法已在实验中开发出来。该技术利用在压力下输送的液氮来消融心脏神经支配的主要来源，即围绕主动脉、肺动脉和静脉的外膜。该技术已通过生理手段在体内以及通过定量免疫组织化学和心肌去甲肾上腺素浓度测量在体外进行了实验验证。一名35岁女性出现顽固性心前区疼痛，心外膜冠状动脉正常，患有肥厚型心肌病。她的症状对最大程度的药物治疗无效，并且被认为不适合进行传统的心肌血运重建、自体移植或同种异体移植以及随之而来的移植冠状动脉疾病风险。因此，她通过实验室开发的方法接受了心脏去神经支配。有定量免疫组织化学证据表明存在心脏外去神经支配，同时她症状有相当大的改善。这种改善在超过16个月的随访期内持续存在。
