PTSMA治疗肥厚型梗阻性心肌病疗效观察

The efficacy of percutaneous transluminal septal myocardial ablation on hypertyophic obstructive cardiomyopathy, a middle-term follow up result

目的:评价经皮经腔间隔消融术 (PTSMA)治疗肥厚型梗阻性心肌病 (HOCM)疗效。 方法:用心导管对 3例HOCM患者行 PTSMA术 ,分别于术前及术后 3个月、1年、2年用超声心动图测量左室流出道压力阶差 (L VOGT)、室间隔厚度 (IVST)、左室流出道宽度 (L VOT)、射血分数 (EF)值 ,并观察临床表现。 结果:随访 2年 ,患者 L VOGT、IVST值均有所下降 ,L VOT增加 ,临床症状基本缓解 ,心功能恢复至 ～ 级 ,心脏杂音降至 ～ 级。结论 :PTSMA能显著降低 L VOGT及 IVST、增加 L VOT,可将其作为难治性

Objective: To evaluate the middle term efficacy of three pations with hypertrophic obstructive cardiomyopathy (HOCM) under went percutaneous transluminal septal myocardial ablation (PTSMA), follow up results of 3 months, 1 year, 2 years respectively. Methods: The three patients with HOCM underwent PTSMA, The thickness of septal myocardium (IVST) width of left ventricular out tract pressure gross (LVOGT) and the enjection function (EF) and the width of left ventricular out tract(LVOT) were measured, by the color Doppler before and 3 months and 1 years and 2 years after PTSMA, Clinical presentations were closely monitored. Results: The LVOGT and IVST reduced from (64.2±7.8)mmHg, (21.3±5.8)mm before ablation to (8.45±2.2)mmHg, (10.3±2.4)mm respectively at 2 years after PTSMA. The LVOT increased from (7.9±2.6)mm before ablation to (18.3±3.6)mm, The EF increased from before ablation to (67.4±3.8)%, clinical symptoms almost disappeared, cardiac function capacity was improved (before ablation is NHA class Ⅳ after ablation is NHA classⅡ), systemic heart murmur significantly reduced. Conclusions: PTSMA can signific: antly reduced the IVST and LVOGT, also improve the LVOT after PTSMA the result improves gradually as time goes on. PTSMA is an effective therapy for uncontrolled HOCM patient.