经皮室间隔化学消融治疗肥厚型梗阻性心肌病疗效观察

The Efficacy of Percutaneous Transluminal Septal Myocardial Ablation on Hypertrophic Obstructive Cardiomyopathy

肥厚型梗阻性心肌病(hypertrophic obstructive car-diomyopathy,HOCM)是原发性心肌病的一种特殊类型,约占肥厚型心肌病患者的25%[1]。临床治疗的目的是使流出道变宽,狭窄减轻,从而达到缓解流出道梗阻,减轻症状,降低猝死率。

Objective To evaluate the short-term efficacy of percutaneous transluminal septal myocardial ablation（FPSMA ） on hypertrophic obstructive cardiomyopathy（HOCM）. Methods 28 patients with symptomatic HOCM underwent FISMA by Sigwart method were selected from November 2005 to Vebmary 2009,. The pressure gradient of left ventricular out floow tract （LVOTG）, thickness of septal myocardium （IVS） ,width of left ventricular out floow tract （LVOT） ,ejection fraction （EF） and electrocardiograms （ECG） were measured before and 1 month after PISMA. Results FISMA was performed 28 patients, the average alcohol injected into Septal branch was 2.46mL; the average L VOTPG before operation was （67.73 ± 33.62）mmHg, and after operation it reduced to （29.50±25.67）nmfftg （ P 〈 0.01） and IVS was（24.72 ± 6.51）ram and（22.26 ± 5.92）mm respectively （P 〈 0.01）. 5 patients had transitory Ⅲ°atrio-ventricular block （AVB） during operation, new-onset complete right branch block （CRBB） was found in 12 patients and all of them were persistent, all the clinical symptoms were relieved more or less. Conclusions FISMA could significanty reduce LVOTG and the thickness of septal moyocardium.