The Compare Of Effectiveness And Safety Of Ablating Different Septal Branch For Patients Over60with Hypertrophic Obstructive Cardiomyopathy

ObjectiveTo retrospectively investigate the immediate(≤30days) effectiveness and safety ofablating different septal branch for aged patients(age≥60years) with hypertrophicobstructive cardiomyopathy(HOCM) treated by percutanous transluminal septalmyocardial ablation(PTSMA).MethodsRetrospectively analyzed the data from patients with HOCM treated by PTSMA fromJuly1998to July2013, including in clinical data, and the results of PTSMA to assessthe complication and results of aged HOCM patients.ResultsThere were43aged patients with HOCM received PTSMA. There were31agedpatients received ablating first septal branch (S1), whose left ventricular outflow tractpressure gradient(LVOTPG) at rest and post premature beat dropped significantlyafter operation (16.13±17.65vs75.87±36.07, P<0.001；41.42±21.73vs126.58±38.22, P<0.001）; there were7aged patients received ablating second septal branch (S2),whose left ventricular outflow tract pressure gradient(LVOTPG) at rest and postpremature beat dropped significantly after operation (5.0vs28.0, P=0.011；30.0vs55.0, P=0.002）and there were5aged patients received ablating first and second septalbranch (S1+S2), whose left ventricular outflow tract pressure gradient(LVOTPG) at restand post premature beat dropped significantly after operation（⊿57.0vs⊿15.0vs⊿103.0, P=0.04）. And the decline value at rest had significantdifference （⊿57.0vs⊿15.0vs⊿103.0, P=0.04）among three groups. And the declinevalue at post premature beat had no significant difference （⊿80.0vs⊿65.0vs⊿100.0,p=0.649）among three groups. Subgroup analysis shown the decline value at rest hadsignificant difference （⊿57.0vs⊿15.0, P=0.005）between ablating S1group andablating S2group. During operation and30days after operation, the total complicationrate had no significant difference among three groups.ConclusionsThe ablating different septal branch for HOCM was effective for aged patients withHOCM received PTSMA. PTSMA of ablating first septal branch was more effective foraged patients with HOCM than ablating second septal branch.