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目的:总结经皮室间隔心肌化学消融术(PTSMA)联合经皮冠状动脉介入治疗术(PCI)治疗肥厚型梗阻性心肌病(HOCM)伴冠心病(CHD)患者的近期疗效及安全性。方法:对HOCM伴CHD5例患者的临床资料及同期行PTSMA联合PCI的围术期情况进行回顾性分析。结果:5例均术后胸痛、气短症状消失,静息左室流出道压力阶差较术前明显降低(27.00±7.68∶75.4±13.98,P<0.01),左室射血分数较术前略有下降,但差异无统计学意义(0.57±0.03∶0.65±0.08,P>0.05)。5例术中均发生胸痛,发生完全性右束支传导阻滞1例,一过性Ⅲ度房室传导阻滞2例。结论:HOCM伴CHD患者同期行PTSMA联合PCI是安全、有效的。
Objective: To summarize the short-term curative effect and safety of percutaneous transluminal septal myocardial chemical ablation (PTSMA) combined with percutaneous coronary intervention (PCI) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and coronary heart disease (CHD). Methods: The clinical data of 5 HOCM patients with CHD and the perioperative period of PTSMA combined with PCI during the same period were analyzed retrospectively. Results: The postoperative chest pain and shortness of breath symptoms disappeared. The pressure gradient of resting left ventricular outflow tract was significantly lower than that before operation (27.00 ± 7.68:75.4 ± 13.98, P <0.01). The left ventricular ejection fraction There was no significant difference (0.57 ± 0.03: 0.65 ± 0.08, P> 0.05). All 5 patients had chest pain, complete right bundle branch block in 1 case, transient grade III AV block in 2 cases. Conclusions: PTSMA combined with PCI during HOCM with CHD is safe and effective.