ABC | Volume 112, Nº4, April 2019

Original Article Yang Li Risk factors for PTSMA complications Arq Bras Cardiol. 2019; 112(4):432-438 to 23.21%, which was not different from that in other experienced centers. 7,21 Therefore, PTSMA procedures might be safer and more efficient in experienced centers. Limitations There were several important limitations in the present study. (1) One of the most important limitations was that only a limited number of HOCM patients were examined. (2) In this study, these PTSMA procedures were elected based on the preferences of patients and the physician. Therefore, patients were not consecutively enrolled. If the patient was an older person, or had significant comorbidity conditions, PTSMA was not that strongly suggested. For older patients, especially those with concomitant disease and without enough insurance, medication or a less aggressive approach of PTSMA might be a better or the only choice, even with the incomplete elimination of LVOT obstruction. (3) The decision regarding the target septal artery was taken based on available angiographic images, as well as the assistance of MCE. However, we still could not rule out that more targeted imaging might have yielded more anatomically correct values. Conclusion In summary, PTSMA was effective in reducing LVOTG in HOCM patients. Hypertension was the only independent risk factor for PTSMA procedure-related complications after multivariate logistic regression analysis. In addition, PTSMA procedures might be safer and more efficient in experienced centers, according to the analysis result for the learning curve. Author contributions Conception and design of the research, Statistical analysis, Obtaining financing, Writing of the manuscript and Critical revision of the manuscript for intellectual content: Cheng‑Yang L; Acquisition of data and Analysis and interpretation of the data: Cheng-Yang L and Yun-Qi S. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Hospital da Província de Liaoning. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 1. Kimura A. Contribution of genetic factors to the pathogenesis of dilated cardiomyopathy: the cause of dilated cardiomyopathy: genetic or acquired? (genetic-side). Circ J. 2011;75(7):1756-65. 2. Parry DJ, Raskin RE, Poynter JA, Ribero IB, Bajona P , Rakowski H, et al. Short andmedium termoutcomes of surgery for patients with hypertrophic obstructive cardiomyopathy. Ann Thorac Surg. 2015;99(4):1213-9. 3. 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