附件二尖瓣组织(AMVT)是一种罕见的先天性异常,有时会导致左心室流出道(LVOT)阻塞。我们报告了一例72岁的肥厚型梗阻性心肌病(HOCM)并发AMVT的女性。在我们医院就诊的患者有心悸和呼吸急促。经胸超声心动图显示HOCM的诊断和LVOT内部的异常结构。经食管超声心动图显示AMVT。我们最初用口服药物治疗患者,但由于副作用,患者不能服用目标剂量,症状也没有改善.我们建议手术治疗,但病人拒绝了.通过三维经食管超声心动图评价AMVT与周围组织的关系,我们确定经皮室间隔心肌消融术(PTSMA)可能成功.第一个PTSMA无效,但第二个手术显示压力梯度和症状显著改善。患有HOCM和合并AMVT的患者有严重的LVOT压力梯度,PTSMA表现优异。由于我们经历了一个罕见的病例,并且能够经皮治疗,我们报告了与文献相关的发现。
■本病例研究重点介绍了1例肥厚型梗阻性心肌病(HOCM)和副二尖瓣组织(AMVT)患者经皮经皮间隔心肌消融术(PTSMA)的成功应用。ThekeyobjectiveistounderstandPTSMAcanbeaneffectivetreatmentoptionforHOCMwithTypeIIaAMVT,以仅附着于二尖瓣小叶为特征,当手术干预不是首选时,加强对这种罕见疾病的管理。
Accessory mitral valve tissue (AMVT) is a rare congenital anomaly that sometimes causes left ventricular outflow tract (LVOT) obstruction. We report the case of a 72-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) complicated by AMVT. The patient presented at our hospital with palpitations and shortness of breath. Transthoracic echocardiography revealed a diagnosis of HOCM and an abnormal structure inside the LVOT. Transesophageal echocardiography revealed an AMVT. We initially treated the patient with oral medication, but due to side effects, the patient could not take the target dose and her symptoms did not improve. We suggested surgical treatment, but the patient refused. By evaluating the relationship between AMVT and the surrounding tissues using three-dimensional transesophageal echocardiography, we determined that percutaneous septal myocardial ablation (PTSMA) might be successful. The first PTSMA was not effective, but the second procedure showed significant improvement in the pressure gradient and symptoms. The patient with HOCM and concomitant AMVT had a severe LVOT pressure gradient, and PTSMA was performed with excellent results. Since we experienced a rare case and were able to treat it percutaneously, we report our findings in relation to the literature.
UNASSIGNED: This case study highlights successful use of percutaneous septal myocardial ablation (PTSMA) in treating a patient with hypertrophic obstructive cardiomyopathy (HOCM) and accessory mitral valve tissue (AMVT). The key objective is to understand PTSMA can be an effective treatment option for HOCM with Type IIa AMVT, characterized by the attachment only to the mitral leaflets, when surgical intervention is not preferred, enhancing management of this rare condition.