Value of myocardial contrast echocardiography in transcoronary ablation of septal hypertrophy for hypertrophic obstructive cardiomyopathy / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the role of myocardial contrast echocardiography (MCE) to select target vessel, to monitor the opacification zone and to avoid complications during transcoronary ablation of septal hypertrophy(TASH) for hypertrophic obstructive cardiomyopathy(HOCM). Methods In 37 HOCM patients cardiac apex four chamber view, parasternal left ventricular long axis view and left ventricular short axis view were recorded after injection of the myocardial agents and absolute ethanol 5 minutes later respectively. And the opacification zones of the myocardial agents and absolute ethanol were observed. Results Among 37 patients,2 patients gave up treatment because of no appropriate vessel to provide ablation by coronary Doppler flow imaging.Two of 37 patients gave up treatments and did not undergo myocardial contrast echocardiography because of diffused coronary arteries in coronary angiography. Among 33 patients who underwent MCE, 5 patients gave up TASH including one of the opacification of left ventricular mammary muscles, one of the opacification of right ventricular and right ventricular mammary muscles, one for the opacification zone out of the target area and two for the large opacification zone. Other 28 patients underwent TASH successfully. Just after operations and 7 days, left ventricular outflow tract pressure gradient decreased at no less than 50%. Distribution zone of absolute ethanol was smaller than that of myocardial opacification zone in some patients. Conclusions MCE is a credible reference for selection of target vessels in TASH for HOCM.