オブストラクティブ・ハイパートロフィック・カルジオミオパシーのためのアルコールセプトアブレーションの結果
Paul Sorajja1, Uma Valeti, Rick A Nishimura
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. paul.sorajja@mayo.edu
Circulation
|July 2, 2008
まとめ
アルコールセプトアブレーションは,経験豊富なセンターで,阻害性高縮性心筋病症の症状を効果的に治療しますが,合併症率はミエクトミーよりも高いです. 若い患者は,症状の解消のためにミエクトミーからより多くの利益を得ることができます.
科学分野:
- 心臓病学 心臓病学
- 介入性心臓病学 介入性心臓病学
- 心臓外科手術について
背景:
- 薬剤耐性高縮性心筋病変に対するアルコール隔膜切除の臨床効果は十分に確立されていません.
- この研究では,専門の高縮性心筋病症センターでのアルコールの隔膜切除の結果を評価しています.
研究 の 目的:
- 阻害性高縮性心筋病変症の患者におけるアルコール隔膜切除の有効性と安全性を評価する.
- セプタルミエクトミーによるアウトカムを比較するために.
主な方法:
- アルコールセプトアブラション (1998年~2006年) を受けた138人の患者の遡及的分析.
- septal myectomyを受けた年齢と性別をマッチした患者との比較.
- 処置による合併症,死亡率,症状解消の評価.
主要な成果:
- アルコールセプトの切除は,ミエクトミー (5%) よりも高い合併症率 (1.4%の死亡,20%のペースメーカー) を示した.
- 死亡率のない4年生存率は88.0%で,ミエクトミーに似ています.
- 患者の51%が無症状になりましたが,ミエクトミーは65歳未満の患者にとって症状の解消がより良くなりました.
結論:
- アルコールセプトアブレーションは,経験豊富なセンターで実施された場合,閉塞性高縮性心筋病の症状緩和に有効です.
- 切除の手続きの合併症率は,骨髄切除の手術の合併症率を上回っている.
- 筋切除は,より若い患者 (<=65歳) の症状解消に優れている可能性があります.
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