Applied value of coronary Doppler flow imaging in percutaneous transluminal septal myocardial ablation of hypertrophic obstructive cardiomyopathy / 中华超声影像学杂志

ABSTRACT

Objective To show left anterior descending artery and interventricular septal branch Doppler flow and Doppler flow spectrum using coronary Doppler flow imaging,provide reference to select target artery,and judge collateral circulation formation after percutaneous transluminal septal myocardial ablation (PTSMA) of hypertrophic cardiomyopathy. Methods In 28 patients with hypertrophic cardiomyopathy left anterior descending artery and interventricular septum branch flow were displayed using coronary flow Doppler imaging system before and after PTSMA,and flow velocity were measured by Doppler spectrum. Results In 22 patients the target arteries were successfully selected in the first time using coronary flow Doppler imaging combined with coronary angiography and proved by the results of PTSMA. In 2 patients PTSMAs were performed successfully after additional choosing other interventricular septal branch. Therefore,PTSMAs in 24 patients were performed effectively in total. In 4 patients PTSMAs were given up due to vessel thinness and suffusion of interventricular septal branch in 2 patients,myocardial contrast agent distributing right ventricular and right ventricular papillary muscle during operation in one patient and contrast agent distributing left ventricular papillary muscle in another patient. Left ventricular flow tract pressure rebounded in 5 patients postoperatively,and neighboring interventricular septum branch extending to melting area were seen in 3 patients accompanied by flow velocity increasing. Melted vessel nub markedly prolonged in 1 patient. Conclusions Coronary Doppler flow imaging can directly reveal interventricular septum branch flow in hypertrophic cardiomyopathy,provide detailed hemodynamic information for myocardial PTSMA and monitor PTSMA for hypertrophic cardiomyopathy effectively and reliably.