A Retrospective Clinic Study Of Percutaneous Transluminal Septal Myocardial Ablation For Hypertrophic Obstructive Cardiomyopathy

Objective: The aim of this retrospective comparative study was evaluating theinfluence factors of percutaneous transluminal septal myocardial ablation forhypertrophic obstructive cardiomyopathy.Methods:Atotal of37refractory HOCM patients receiving PTSMAin cardioloydepartment of Shang hai6thpeople’s hospital were enrolled. The enrolled patientswere grouped according to the major clinical evaluation criteria(myocardial contrastechocardiography and injection volume of anhydrous ethanol),then the indexes ofLVOTPG,myocardial injury(peak of CKMB) and relief of clinic syndromes weredetected at current time and6-12months late after the operation.Results:1. Finally,36patients received the operation of PTSMA with average age (56.3±16.2years) and anhydrous ethanol usage(（2.79±2.19ml) during2008-2013.LVOTPGwere reduced from73.73±31.91to31.78±19.4measured by transthoracicechocardiography and from101.47±30mmHg to20.84±14.4detected by catheterafter myocardial ablation, with significant difference(P<0.01);2. The current treatment effects between two groups depend on the selection oftarget artery by MCE(whether the target artery was definite)were similar（P>0.05）after6-12months follow-up,the long time clinic effects were better in the group with definite target artery of ablation,accompanying with significantrelief of syndromes（P<0.01）;3. The clinic effects of low（<2ml）and high dose groups of anhydrous ethanol weresimilar(P>0.05), however, the myocardial injury and complications were muchlower in low dose group of anhydrous ethanol.（P<0.01）Conclusion: Treatment of PTSMAfor HOCM, could obviously reduce HOCM andimprove clinical symptoms of patients; The PTSMAwith targeting coronary septalbranch guided by MCE could achieve better clinic efficacy; Low dose anhydrousethanol has the similar curative effect compared with high dose, however, with muchlower myocardial injury.