室间隔心肌化学消融术治疗肥厚型梗阻性心肌病  

PERCUTANEOUS TRANSLUMINAL SEPTAL MYOCARDIAL ABLATION FOR TREATMENT FOR HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY

作　　者：王磊[1] 李克清[1] 黄树温[1] 张雁[1] 牟瑞起[1] 王荣彬[1] 

机构地区：[1]德州市人民医院心内科,德州市253014

出　　处：《滨州医学院学报》2003年第4期254-255,共2页Journal of Binzhou Medical University

摘　　要：目的 :探讨经皮室间隔心肌化学消融术 ( PTSMA)治疗肥厚型梗阻性心肌病 ( HOCM)的临床疗效及安全性。方法 :对 5例 HOCM行经皮室间隔心肌化学消融术。结果 :5例患者均手术成功。术终左心室与主动脉压阶差 ( LVOTC)由 ( 72± 2 3) mm Hg下降至术后的 ( 36± 2 3) mm Hg。术后 1 0 d测定 UCG,提示室间隔厚度 /左心室后壁厚度比值下降 0 .7± 0 .42 ,左心室流出道内径平均增加 ( 5 .1± 4.2 ) mm。 2例术中出一过性 度房室传导阻滞 ( AVB) ,2～ 1 0 min内均自行恢复。 2例出现完全性右束支阻滞 ,且出院时心电图仍遗留。 PTSMA术后住院期间 ,5例病人均无晕厥、心绞痛发作 ,心悸、气短及胸闷症状均明显减轻 ,听诊心脏杂音均较术前减轻 ～ 级 ,心功能恢复 ～ 级。结论 :PTSMA是治疗 HOCM的一种新的介入技术 ,其临床近期疗效满意 。Objective:To evaluate the immediate clinical efficiency and safety of percutaneous transluminal septal myocardial ablation (PTSMA) in the treatment of hypertrophic obstructive cardiomyopathy (HOCM).Methods:PTSMA was performed in 5 patients with HOCM.Results:The success rate of PTSMA was 100% in the 5 cases.Mean LVOTG decreased from 72±23 mmHg to 36±23 mmHg.The mean ratio of the thickness of ventricular septal to that of left ventricular posterior wall decreased by 0 7±0 42 and the mean diameter of left ventricular out flow tract increased by 5 1±4 2 mm 10 days after procedure.The temporary Ⅲ° AVB occurred in 2 cases during operation,but recovered within 2-10 min.CRBBB occurred in 2 cases during the ablation and lasted until discharge.After PTSMA,none of the 5 patients had syncope or angina and their symptoms of palpitation and short breath improved significantly.The heart murmur decreased by Ⅰ-Ⅱ grades and heart function had improvement of Ⅰ-Ⅱ grades,too.Conclusion:PTSMA is a new,safe and effective interventional technique for treatment of HOCM.

关 键 词：心肌病 肥厚型 室间隔 化学消融术 介入治疗 

分 类 号：R542.2[医药卫生—心血管疾病]