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首页> 外文期刊>Texas Heart Institute journal / >The '1st septal unit' in hypertrophic obstructive cardiomyopathy: a newly recognized anatomo-functional entity, identified during recent alcohol septal ablation experience.
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The '1st septal unit' in hypertrophic obstructive cardiomyopathy: a newly recognized anatomo-functional entity, identified during recent alcohol septal ablation experience.

机译：肥厚性梗阻性心肌病中的“第一间隔单位”：一种新近认可的解剖功能实体，在最近的酒精间隔消融经验中被发现。

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摘要

In hypertrophic obstructive cardiomyopathy, selective and asymmetric hypertrophy results in a stenotic subaortic channel, which is further narrowed by a Venturi effect (suctioning of the anterior leaflet, manifested by systolic anterior motion of the mitral valve). Better understanding of these essential pathophysiologic mechanisms has led to the definition of a new anatomo-functional entity, the 1st septal unit, which consists of the basal interventricular septal hypertrophy and its related septal arterial branches. As an alternative to surgical myomectomy, alcohol septal ablation is an effective method of reducing subaortic stenosis and improving mitral valve function. After alcohol ablation, global negative remodeling of the hypertrophied left ventricle eventually ensues. This review presents specific anatomic and functional features of a newly identified pathophysiologic entity (the 1st septal unit) in relation to the clinical manifestations and natural history of hypertrophic obstructive cardiomyopathy. This relationship is also relevant during the performance of alcohol septal ablation interventions: related operative suggestions are provided for optimizing subaortic stenosis relief during septal ablation and for preventing complications.
机译：在肥厚性梗阻性心肌病中，选择性的和不对称的肥大导致主动脉瓣下狭窄，其通过文丘里效应（前叶的抽吸，由二尖瓣的收缩前运动表现出来）进一步变窄。对这些基本病理生理机制的更好理解导致了对新的解剖功能实体的定义，即第一间隔单元，该单元由基底室间隔增生及其相关的间隔动脉分支组成。作为外科子宫肌瘤切除术的替代方法，酒精中隔消融术是减少主动脉瓣狭窄和改善二尖瓣功能的有效方法。酒精消融后，肥大的左心室最终出现整体阴性重塑。这篇综述介绍了肥厚型梗阻性心肌病的临床表现和自然史相关的新发现的病理生理实体（第一中隔片）的具体解剖学和功能特征。这种关系在进行酒精中隔切除术的过程中也很重要：提供了相关的手术建议，以优化中隔切除术中主动脉瓣下狭窄的缓解并预防并发症。

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