论文部分内容阅读
目的 评价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)近期疗效 ,并探讨其方法学。方法 31名HOCM患者接受PTSMA治疗 ,6例采用心肌声学造影监测判断消融靶血管。结果 31例患者均成功实施PTSMA治疗 ,患者术前平均跨左心室流出道压力阶差 (71.6±25.7)mmHg,术中球囊充盈15min后为 (29.1±15.6)mmHg,消融术毕为 (21.6±7.7)mmHg,与术前比较均有显著下降 (均P<0.05) ;临床状况显著改善18例 ,明显改善9例 ,改善不显著4例 ;1例患者发生迟发性高度房室传导阻滞 ,经积极药物处理后传导阻滞消失 ,无死亡和需行永久性起搏治疗者。 结论 PTSMA手术是HOCM患者一项有效、相对安全的治疗方法。
Objective To evaluate the short-term curative effect of transcatheter arterial chemoembolization (PTSMA) on hypertrophic obstructive cardiomyopathy (HOCM) and to explore its methodology. Methods Totally 31 HOCM patients underwent PTSMA treatment and 6 underwent myocardial contrast echocardiography to evaluate target vessel ablation. Results All 31 patients were successfully treated with PTSMA. The average preoperative left ventricular outflow tract pressure gradient (71.6 ± 25.7) mmHg, intraoperative balloon filling 15.1 (29.1 ± 15.6) mmHg, ablation completed (21.6 ± 7.7) mmHg, which were significantly lower than those before operation (all P <0.05). The clinical conditions were significantly improved in 18 cases, significantly improved in 9 cases and no significant improvement in 4 cases. One patient developed delayed atrioventricular conduction resistance Hysteresis, after the active drug treatment block disappeared, no death and need to be treated with permanent pacing. Conclusion PTSMA is an effective and relatively safe treatment for HOCM patients.