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目的:探讨经皮室间隔心肌消融术(PTSMA)治疗梗阻性肥厚型心肌病(HOCM)方法及疗效。方法:回顾分析采用心脏超声声学造影(MCE)介导下行PTSMA治疗的60例HOCM患者术后近期及中期的随访资料。结果:60例患者中54例术后左室流出道压差(静息和激发)较术前下降>50%,6例下降>30%但<50%,PTSMA成功率100%;术后随访2周～6年,平均2.5年,56例患者临床症状明显改善或消失,3例症状复发,1例术后1年死于扩张型心肌病并发心力衰竭。无一例需安装永久心脏起搏器。结论:PTSMA治疗HOCM近期及中期疗效显著、安全。
Objective: To investigate the treatment of obstructive hypertrophic cardiomyopathy (HOCM) by percutaneous transluminal myocardial septal myocardial ablation (PTSMA) and its curative effect. Methods: The follow-up data of 60 cases of HOCM patients undergoing cardiac ultrasound-enhanced ultrasound (MCE) -mediated down-stream PTSMA were retrospectively analyzed. Results: Among the 60 patients, the postoperative left ventricular outflow tract pressure difference (resting and stimulated) was decreased by 50% compared with that before operation. The 6 cases were decreased by> 30% but <50%, the PTSMA success rate was 100% 2 weeks to 6 years, an average of 2.5 years, 56 patients with clinical symptoms improved or disappeared, 3 patients with recurrent symptoms, 1 patient died of dilated cardiomyopathy at 1 year after operation with heart failure. No need to install a permanent pacemaker. Conclusion: The efficacy of PTSMA in the treatment of HOCM in the short and medium term is significant and safe.