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Pericardium-covered stent for septal myocardial ablation in hypertrophic obstructive cardiomyopathy
J Gaspar1, M A Martínez-Ríos, C Vonderwalde
1Department of Interventional Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. jgaspar@mail.internet.com.mx
Insights
A novel stent procedure successfully treated severe hypertrophic obstructive cardiomyopathy (HOCM). This minimally invasive technique reduced the left ventricular outflow tract gradient, improving the patient's functional class.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Hypertrophic obstructive cardiomyopathy (HOCM) is a significant cause of heart failure.
- Severe HOCM can lead to debilitating symptoms and reduced quality of life.
- Current treatments for HOCM have limitations and potential complications.
Observation:
- A patient presented with severe HOCM, classified as New York Heart Association functional class III.
- The patient exhibited a significant left ventricular outflow tract (LVOT) gradient.
- Standard medical and surgical options were considered.
Findings:
- A novel interventional approach was employed using a pericardium-covered stent.
- Selective occlusion of three septal arteries targeting the LVOT gradient was performed.
- Complete reduction of the LVOT gradient was achieved post-procedure.
Implications:
- This case demonstrates the potential efficacy of targeted septal artery occlusion with a novel stent for HOCM.
- The procedure resulted in a significant clinical improvement, with the patient progressing to functional class I.
- This approach may offer a less invasive alternative for managing severe HOCM, warranting further investigation.
Abstract:
This report describes a patient with severe hypertrophic obstructive cardiomyopathy in New York Heart Association functional class III. Complete reduction of left ventricular outflow tract gradient was achieved by the selective occlusion of three target septal arteries with a pericardium-covered stent. The patient's in-hospital course was uneventful and has improved to functional class I.