经皮间隔支化学消融治疗肥厚梗阻性心肌病尤士杰英文.pptxVIP

Percutaneous Septal Myocardial Ablation (PASMA);Introduction;Hypertrophic cardiomyopathy Epidemiological characteristics;Pathophysiologic and clinical characteristics of HOCM;The natural course of outflow tract obstruction;The symptoms;Diastolic dysfunction;systolic function;Myocardial ischemia;Arrhythmia and sudden death ;Risk factors for sudden death ;The purpose of the treatment PTMSA ;PTSMA indication (1);PTSMA indication (2);Hypertrophic Cardiomyopathy Survival According to Outflow Tract Gradient;PTSMA indication (3);Outflow tract obstruction sign in Echocardiograph; Morphologic of HOCM;Our classfication in PTSMA;Target vessel ;Contrast echocardiography method in the target vesse choice;Myocardial - Contrast - Echo in HOCM;Septal Ablation in HOCMMyocardial - Contrast - Echo; ;Echo sequence: Subaortic septum as targetbregion in typical SAM-associated, subaortic obstraction, ( D dotted line) , ;;H. Seggewiss et al, 49th Scientific Sessions ACC, 2000;keys of Technology of PTSMA;The keys of Technology PTSMA;A 51-year-old woman’s LVOT gradient was monitored continuously just before the balloon occlusion . (PG=80mmHg);Her LVOT gradient 10 minutes after septal ablation （PG=12mmHg）;A 36-year-old man’s LVOT gradient tested by Doppler echocardiography before PTSMA (PG=219mmHg);His LVOT gradient 6 months after PTSMA (PG=15mmHg);;;;PG120mmHg before procedure;PG=40mmHg after injection of 4.8 ml alchohol;Great attention ;It is very big septal branch 2.5mm and too long. There is quite danger to PTMSA;PTSMA contraindications;PTSMA complications (1) ;PTSMA complications (2) ;PTSMA shortcomings;PTSMA limitations;PTSMA in Fuwai Hospital;Patient Characteristics;Results of PTSMA;Complications in our patients;Complications in our patients;Follow-up in our patients by echo ;CONCLUSIONS;;;PTSMA indication (1);PTSMA indication (2);Hypertrophic Cardiomyopathy Survival According to Outflow Tract Gradient;A 36-year-old man’s LVOT gradient tested by Doppler