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肥厚型梗阻性心肌病间隔心肌消融术 被引量:4

Percutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy: immediately and middle-term follow-up results
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摘要 目的 评价肥厚型梗阻性心肌病 (HOCM)经皮间隔心肌消融术 (PTSMA)后即刻和中期随访结果。方法  15例药物治疗效果不佳的HOCM病人在心肌声学造影 (MCE)指导下完成PTSMA ,并经超声心动图、心电图、同位素心肌灌注显像评价。结果 左室流出道压力阶差 (LVOTG)由术前( 77 93± 2 2 0 0 )mmHg即刻下降到 ( 14 8± 15 0 )mmHg(P <0 0 0 0 1) ,左室舒张末压即刻平均下降( 5 75± 2 87)mmHg(P <0 0 0 0 1)。平均 8 6个月 ( 6~ 2 0 )随访结果表明心功能 (NYHA)显著改善( 3 4± 0 5比 1 1± 0 4 ,P <0 0 0 1) ,心绞痛症状消失 ,运动耐量显著提高 ,血流动力学改善状况稳定。结论 PTSMA是HOCM病人治疗有效的非外科手段 ,中期随访结果令人满意。 Objective To evaluate the immediate and follow-up results of percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods 15 patients with HOCM refractory to medication successfully underwent PTSMA under myocardial contrast echocardiography. Results The left ventricular outflow gradients (LVOTG) were reduced significantly (77.93±22.00) mm Hg to (14.8±15.0)mm Hg (P< 0.000 1)immediately with a mean decrease of (5.75±2.87) mm Hg (P<0.001) in left ventricular end diastolic pressure. The scores of SAM and mitral regurgition During a mean of 8.6±3.8(6~22) months follow -up ,the patients heart function (NYHA) were greately improved(3.4±0.5 vs 1.1±0.4, P<0.001),and disappearence of angian pectorsis,and exercise endurance improvement with steady hemodynamic improvement. Conclusion PTSMA is effectively non-surgical treatment method for drug-refractory patients with HOCM.
出处 《中华内科杂志》 CAS CSCD 北大核心 2001年第10期661-665,I001,共6页 Chinese Journal of Internal Medicine
关键词 肥大性心肌病 导管消融术 随访研究 Cardiomyopathy,hypertrophic Catheterl Ablation Follow-up studies
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