Effect Of Myocardial Contrast Echocardiography In Patients With Hypertrophic Obstructive Cardiomyopathy In Percutaneous Transluminal Septal Myocardial Ablation

Objective To evaluate the value of myocardial contrast echocardiography(MCE) with percutaneous transluminal septal myocardial ablation(PTSMA) for hypertrophic obstructive cardiomyopathy (HOCM).Methods In109patients MCE was carried out after injection of the myocardial agents in far-end to target vessels immediately. The opacification zones of the myocardial agents were observed to select target vessels, decide the outcome and treatment prescription.Results MCE was carried out in all109patients.101underwent PTSMA, All patients have no complications. There was significant difference between the left ventricular outflow tract pressure gradient (Left ventricular outcome pressure gradients, LVOTPG) before operation and immediately after operation (78±30.7mmHg vs.37.4±30mmHg,p<0.001). Further, the LVOTPG of postoperative follow-up in6moths decreased to33.3±23.4mmHg compared with the results before (p<0.001).The unhealthy outcome of4patients were forecasted by MCE, and were verified in follow-up. Pressure gradients of the8patients did not fall obviously. So they underwent Morrow operation insteadly.Conclusions In PTSMA, MCE play a key role to decide outcome, choose appropriate target vessels, avoid complications, and decide treatment prescriptions.