Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy
- VernacularTitle:经皮腔内室间隔心肌消融术治疗梗阻性肥厚型心肌病57例
- Author:
Renpeng WANG
;
Haiyan WAN
;
Xi SU
- Publication Type:Journal Article
- Keywords:
Cardiomyopathy hypertrophic;
Myocardial ablation
- From:
Chinese Journal of Interventional Cardiology
1993;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effectiveness and methodology of percutaneous transluminal septal myocardial ablation (PTSMA). for hypertrophic obstructive cardiomyopathy (HOCM). Methods PTSMA with Sigwart's Method were performed in 57 patients with symptomatic HOCM from September 1999 to January 2005. Improvements were made about pressure monitoring, echocardiography guiding, the ablation procedure and the evaluation criteria of the operation. Results About 0.6-9.0 mL of absolute alcohol were consumed during PTSMA in each patient with 1-5 target septal branchs ablated per case. The resting and provoked left ventricular outflow tract pressure gradient monitored by catheter was reduced over 50% compared with preoperation level in all 57 cases. Two out of four cases with ECT exam had septal myocardial radioactive absence. During the follow-up of 2 weeks to 5 years, the clinical symptoms such as syncope, diziness, angina, palpitation and dyspnea, disappeared or were relieved in 54 cases compared with preoperation status. Two cases regained the above symptoms not long after the operation. One patient showed improvement in clinical symptoms and echocardiographic examination in 6 monthes, but she died of dilated congestive cardiomyopathy at 18 monthes after PTSMA. Follow-up echocardiographic examination was completed in 43 cases at 6 monthes and in 34 cases at 12 monthes after PTSMA. Further improvement was shown on UCG compared with 2 weeks after the operation. Some patients had transient or nonsustained ventricular tachycardia and atrioventricular block. Anteroseptal myocardial infarction was observed in 4 patients and 1 of them was accompanied by inferior myocardial infarction. Conclusion Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy is safe and effective. Improvements have to be made for more satisfactory results of PTSMA.
