肥厚型梗阻性心肌病经皮经腔间隔心肌消融术与室间隔心肌切除术疗效比较  

Comparable effects of percutaneous transluminal septal myocardial ablation and subaortic ventriculotomy in treating patients with hypertrophic obstructive cardiomyopathy, an echocardiography follow-up study

作　　者：李靖[1] 刘延玲[2] 何青[1] 乔树宾[3] 凤伟[4] 吕秀章[2] 朱振辉[2] 凌雁[2] 王剑鹏[2] 

机构地区：[1]北京医院心血管内科,100730 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院超声科 [3]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院内科 [4]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院外科

出　　处：《中华心血管病杂志》2006年第8期695-698,共4页Chinese Journal of Cardiology

摘　　要：目的应用超声心动图比较肥厚型梗阻性心肌病患者经皮经腔间隔心肌消融术与室间隔心肌切除术的疗效。方法分别于经皮经腔间隔心肌消融术及室间隔心肌切除术前、后测量肥厚型梗阻性心肌病患者左室流出道压差,比较术前及术后压差。结果肥厚型梗阻性心肌病患者在进行经皮经腔间隔心肌消融术与室间隔心肌切除术后,左室流出道压差均较术前明显减低。经皮经腔间隔心肌消融术肥厚型心肌病患者术前左室流出道压差(99±19)mm Hg(1 mm Hg=0.133 kPa),术后降至(36±20) mm Hg(P<0.05)。进行室间隔心肌切除术肥厚型心肌病患者术前左室流出道压差(117±32) mm Hg,术后降至(28±17) mm Hg(P<0.05)。经皮经腔间隔心肌消融术与室间隔心肌切除术患者术后左室流出道压差差异无统计学意义[(36±20)mm Hg比(28±17)mm Hg]。结论经皮经腔间隔心肌消融术可以明显减低肥厚型梗阻性心肌病患者左室流出道压差,且与室间隔心肌切除术疗效相似。Objective To compare the effect of percutaneous transluminal septal myocardial ablation （n = 20 ） with subaortic ventriculotomy （n = 17 ） in patients with hypertrophic obstructive cardiomypathy by echocardiography. Methods The pre- and post-operation （1 week post procedure ） gradients of left ventricular out flow （LVOTGs） were measured by echocardiography. Results Post operation LVOTGs were significantly reduced than that of pre-operation in patients treated with either percutaneous transluminal septal myocardial ablation [ （36±20 ）vs. （99 ± 19） mm Hg （1 mm Hg =0. 133 kPa）, P 〈 0. 05 ], or subaortic ventriculotomy [ （ 28 ± 17 ） vs. （ 117 ± 32 ） mm Hg ]. Post operation LVOTGs were also similar with the two procedures [ （ 36 ± 20 ） vs. （ 28 ± 17 ） mm Hg, P 〉 0. 05 ]. Conclusion Percutaneous transluminal septal myocardial ablation is as effective as subaortic ventriculotomy in treating patients with hypertrophic obstructive cardiomyopathy.

关 键 词：心肌病 肥厚性 导管消融术 超声心动描记术 

分 类 号：R542.2[医药卫生—心血管疾病] R683.42[医药卫生—内科学]