肥厚型梗阻性心肌病化学消融术后中长期疗效观察

The efficacy of percutaneous transluminal septal myocardial ablation on hypertrophic obstructive cardiomyopathy,metaphase and long-term follow up result

目的评价经皮经腔间隔心肌化学消融术(PTSMA)治疗肥厚型梗阻性心肌病(HOCM)的中-长期疗效.方法选择2000年11月～2004年8月共11例HOCM的患者,成功地接受了PTSMA治疗,术后超声随访12～48个月以上,随访观察患者的室间隔厚度(IVS)、左心室流出道宽度(LVOT)、无创性左心室流出道压力阶差(LVOTPG)、心功能变化.结果11例患者均成功地实施了PTSMA,术后IVS、LVOTPG和NYHA较术前有显著改善,P＜0.000 1,术后随访示IVS术后12个月、48个月较术后1周显著改善,P＜0.05.结论PTSMA能显著降低室间隔厚度,改善心功能且稳定,中长期疗效肯定,随术后观察时间的延长疗效有进一步增加的趋势.

Objective TO evaluate the metaphase and long-term efficacy of Percutaneous transluminal septal myocardial ablation（ PTSMA） on hypertrophic obstructive cardiomyopathy（ HOCM）. Methods From november 2000 to august 2004,11 patients with symptomatic HOCM underwent PTSMA by Sigwart methodo llpatients were follow-up 12-48 months, 7 patients among them were follow-up 48 months. The thickness of septal myocardium（ IVS）, width of left ventricular out floow tract（LVOT） ,No-wound LVOTPG and NYHA function class Were measured before and 1 week and 12 months and 48 months after PTSMA. Results PTSMA was performed in 11 patients, The value of IVS, LVOT, LVOTPG and NYHA had improved obviously than before of ablation. Conclusions： metaphase and long-term follow up data showed that PTSMA could significanty reduce the thickness of septal myocardium and expand the width of LVOT and improved the for symptomatic patients with HOCM.