A single-center comparative study of alcohol septal ablation(SA) and surgery myectomy(SM) for refractory hyper-trophic obstructive cardiomyopathy( HOCM)
10.3760/cma.j.issn.1001-4497.2019.01.010
- VernacularTitle:心肌间隔消融术和肌切除术治疗药物难治性肥厚型梗阻性心肌病的单中心对比研究
- Author:
Yan WANG
1
,
2
;
Jiqiang HE
;
Yuechun GAO
;
Yongqiang LAI
;
Ran DONG
;
Tengyong JIANG
Author Information
1. 首都医科大学附属北京安贞医院 北京市心肺血管病研究所心内科 100029
2. 北京市和平里医院心内科 100013
- Keywords:
Hypertrophic obstructive cardiomyopathy;
Septal reduction therapy;
Septal ablation;
Surgery myectomy
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(1):41-44
- CountryChina
- Language:Chinese
-
Abstract:
Objective Septal reduction therapies were recommended for drug-refractory patients with hypertrophic ob-structive cardiomyopathy(HOCM).To explore and compare the effectiveness and safety in patients with hypertrophic obstruc-tive cardiomyopathy(HOCM) treated with surgery myectomy(SM) and alcohol septal ablation(SA).Methods The clinical data of 260 patients performed SA(n=184) or SM(n=76)between September 2002 and September 2014 in our institute were retrospectively reviewed.The t-test, rank sum test and chi-square test were used to compare the differences between the two groups, and the Cox regression model was used for multivariate survival analysis.All-cause mortality, cardiac cause death(peri-operative death were included ) , heart function improvement , procedure-related complications and permanent pacemaker de-pendence( PPM) constituted the main contents of this study .Results Compared with patients treated with SM , patients un-dergone SA were poor heart function status(2.97 ±0.29 vs 2.50 ±0.56, P =0.01), more prevalence of atrial fibrillation( 15.14％ vs 6.80％, P=0.046) and longer follow-up period[(5.4 ±3.8) years vs(2.5 ±2.2) years, P =0.01)].All-cause mortality for SA and SM were 3.3％ and 14.5％ respectively(P=0.001).The fatal cardiac events of SA and SM were 1.63％ and 13.16％ respectively(P<0.001).Sudden cardiac arrest were the main cardiac cause death for both patients trea-ted with SA and SM.The cardiac death of left ventricular systolic dysfunction was main found in patients treated with SM . Heart function improvement(NYHA) after SA and SM were 1.23 ±0.61 and 0.88 ±0.64 respectively(all P <0.01).And SA had a lower procedure-related PPM implantation(1.63％ vs 4.20％, P<0.05).Conclusion Our results shown that SA have survival advantage, lower PPM and similar heart function improvement compared with SM for refractory patients with HOCM.
