经皮腔内冠状动脉室间隔化学消融术治疗梗阻性肥厚型心肌病的近期疗效观察
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Short-Term Efficacy of Percuteneos Transluminal Septal Myocardial Ablation on Hyoertrophic Obstructive Cardiomyopathy
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    摘要:

    目的评价经皮腔内冠状动脉室间隔化学消融术治疗梗阻性肥厚型心肌病的近期疗效。方法选择梗阻性肥厚型心肌病患者29例,利用Sigwart法行经皮腔内冠状动脉室间隔化学消融术,99%无水酒精注入间隔支,并记录注入前后即刻左心室流出道压力阶差和心电图的变化。在消融术前及术后30天通过超声心动图测量室间隔厚度及左心室舒张末直径。结果间隔支内平均酒精注射量为2.97 mL;术后即刻左心室流出道压力阶差平均下降到36.0±9.3 mmHg;术后30天室间隔厚度降低3.2±0.3 mm;2例需要再次另外一支间隔支消蚀;3例患者术中出现一过性完全性房室传导阻滞;所有患者临床症状都有不同程度的缓解。结论经皮腔内冠状动脉室间隔化学消融术能显著降低左心室流出道压力阶差,治疗梗阻性肥厚型心肌病的近期疗效可靠,但应该严格控制适应症,以减少严重并发症发生。

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    Aim Aim To evaluate the short-term efficacy of percuteoust transluminal septal myocardial ablation(PTSMA) on hyoertrophic obstructive cardiomyopathy(HOCM). Methods 29 patients with HOCM were selected underwent PTSMA by Sigwart method.The change of left ventricular outflow-tract gradient(LVOTG) and ECG were monitored before and after septal branche occluded by 99% alcohol.The thickness of septal myocardium and width of left ventricular end-diastolic diameter(LVEDD) were also measured before and 30 days after PTSMA.Results LVOTG was dereased by 36.0±9.3 mmHg after ablation respectively(p< 0.05).The thickness of septal myocardium reduced by 3.2±0.3 mm,30 days after ablation(p<0.05).Nonsustained ventricular tachycardia,bradycardias,bundle branch block and completely atrial-ventricular block were not observed in 30 days.The average usage of alcohol was 2.97 mL.Conclusion PTSMA can significantly reduce LVOTG and has a satisfactory short-term efficacy in the treatment of HOCM.

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刘端绘,海静如,周颖玲,赵洪磊,黄文晖.经皮腔内冠状动脉室间隔化学消融术治疗梗阻性肥厚型心肌病的近期疗效观察[J].中国动脉硬化杂志,2007,15(12):928~929.

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  • 收稿日期:2007-07-04
  • 最后修改日期:2007-12-01
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