60例梗阻性肥厚型心肌病化学消融治疗近期及中期疗效观察

Percutaneous translum inal septal myocardial ablation in 60 patients with hypertrophic obstructive cardiomyopathy:immediate and followup results

目的:探讨经皮室间隔心肌消融术(PTSMA)治疗梗阻性肥厚型心肌病(HOCM)方法及疗效。方法:回顾分析采用心脏超声声学造影(MCE)介导下行PTSMA治疗的60例HOCM患者术后近期及中期的随访资料。结果:60例患者中54例术后左室流出道压差(静息和激发)较术前下降>50%,6例下降>30%但<50%,PTSMA成功率100%;术后随访2周～6年,平均2.5年,56例患者临床症状明显改善或消失,3例症状复发,1例术后1年死于扩张型心肌病并发心力衰竭。无一例需安装永久心脏起搏器。结论:PTSMA治疗HOCM近期及中期疗效显著、安全。

Objective：To investigate the effects of percutaneous transluminal septal myocardial ablation（PTSMA） in patients with hypertrophic obstructive cardiomyopathy（HOCM）. Method：A retrospective study on 60 patients with HOCM underwent PTSMA with application of myocardial contrast echocardiography（MCE）. Result： The rest and provoked left ventricular outflow tract pressure gradient monitored by catheter was reduced more than 50 % compared with the preoperation level in 54 casea, reduced more than 30 % but less than 50% in 6 cases. After following up 2 weeks 6 years, 56 cases had no or less clinical symptoms, 3 cases recurred and one case died from dilated congestive cardiomyopathy at 18 monthes after PTSMA. No patient required permanent pacemaker. Conclusion：PTSMA was an effective and safe treatment for patients with HOCM.