Short-term Efficacy Of Percutaneous Transluminal Septal Myocardium Ablation On Hypertrophic Obstructive Cardiomyopathy

Objective:The present study was designed to evaluate the effects of percutaneous transluminal septal myocardial ablation(PTSMA) on hypertrophic obstructive cardiomyopathy(HOCM) and to provide a scientific and practical basis for further clinical application of PTSMA.Methods:Eight patients with HOCM underwent PTSMA from September 2005 to March 2009. LVOTPG were measured before and after septal branches occluded by 95%alcohol. Transcatheter were measured in 95%alcohol into the left coronary artery in supporting the front before the interval,after the resting state of the left ventricular inflow tract and left ventricular outflow tract of the systolic pressure,calculated before ablation,immediately after ablation of LVOTPG;Preoperative and postoperative evaluation of cardiac function 1 week and recorded,analysis of intraoperative and postoperative ECG and echocardiography data, intraoperative observation and postoperative markers of myocardial injury changes and serious complications and postoperative 3-month follow-up compared with preoperatively. ECG and UCG were recorded and the complications were observed during and 3 months after ablation.Results:LVOTPG was(92.7±24.3) mmHg and(30.5±25.7) mmHg before and after ablation respectively(P＜0.01);NYHA functional class improved from 3.2±0.6 before ablation to 1.8±0.8(P＜0.05).One week after ablation,CPK and CPK-MB both arise and cTnI was positive after ablation.Multiple ventricular extrasystole,nonsustained ventricular tachycardia, bundle branch block and atrio-ventricular block were observed during and after ablation. Anterior wall acute myocardial infarction and severe hemodynamic obstruction in one patient, then died.The remaining patients were 3-month follow-up survival,UCG showed ventricular septal thickness reduced and LVOT improved comparing with preoperation. Conclusions:PTSMA is an effective technique for reducing LVOTG and symptoms in HOCM,long term observation about effects of treatment with PTSMA are necessary in order to determine the definitive significance of the procedure.