The Analysises Of Percutaneous Translumina Septal Myocardial Ablation For Hypertrophic Obstructive Cardiomyopathy

ObjectiveTo analyze the effectiveness and risk factors of complications after percutaneous translumina septal myocardial ablation(PTSMA) in hypertrophic obstructive cardiomyopathy(HOCM)MethodsA total of30patients with HOCM subjected PTSMA, to sum up datas of their gender、age、intraventricular septem (IVS) thickness、the width of left ventricular outflow tract、left ventricular outflow tract pressure gradient (LVOTG) in resting state、the amount of alcohol in the ablation、the number of ventricular septal branches in the ablation、LVOTG in the immediate state of post-ablation and the occurrence of complication (including myocardial infarction、inductional block、malignant ventricular arrhythmias and cardiac death) and to filter the key and independent factors.ResultsProcedure success was achieved in twenty-eight patients, Success rate was93.3%..LVOTG in the immediate state of post-ablation decreased significantly. Complete abolition of the pressure gradient observed in4patients(13.3%), a basal residual gradient<30mmHg was observed in16patients(53.3%). It was found that decreased more than50%in8cases(26.7%) soon after the injection. Twenty-seven patients were adjusted the complication, mainly several arrhythmias. Complete right bundle branch block was observed in16patients, complete left bundle branch block was observed in1patient and left anterior bundle branch block in2patients. Permanent pacemaker implantation is required in1patient for sustained trifascicular block.1patient death in procedure. The consumption of alcohol is the independent factor to the occurrence of complication. the consumption of alcohol (P=0.021,OR=9.692,95%CI [1.402,66.991]),the consumption of alcohol and the number of intraventricular septal branches in the ablation have the highly correlative relationship(r=0.829, P<0.001).ConclusionPTSMA is safe and effective in mid term for symptomatic patients with HOCM, Long term efficacy and safety need to be further observation. the minor complications of PTSMA were relatively more, but severe cases can cause death. the consumption of alcohol may be the independent risk factor to the occurrence of complication after PTSMA in HOCM, and the number of intraventricular septal branches in the ablation may also have influence to some extent.