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Balloon positioning difficulties during nonsurgical septal reduction therapy in a patient with hypertrophic
1Institute of Cardiology, Collegium Medicum, Jagiellonian University, Krakow, Poland. mcdudek@cyf-kr.edu.pl
Insights
Dual chamber pacing failed for hypertrophic cardiomyopathy. Nonsurgical septal reduction therapy (NSRT) with ethanol provided benefit, despite challenges from severe septal hypertrophy in this patient.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Hypertrophic cardiomyopathy (HCM) can cause left ventricular outflow tract (LVOT) obstruction.
- Dual chamber (DDD) pacing is one therapeutic option for managing HCM-related LVOT obstruction.
Observation:
- This case report details a patient with severe HCM and LVOT obstruction.
- The patient did not respond to previous DDD pacing therapy.
Findings:
- Nonsurgical septal reduction therapy (NSRT) using ethanol was successfully performed.
- NSRT resulted in significant clinical improvement for the patient.
- Massive septal hypertrophy presented procedural challenges during NSRT.
Implications:
- NSRT is a viable treatment option for HCM patients refractory to pacing.
- Careful consideration of septal anatomy is crucial for successful NSRT.
- This case highlights the potential of NSRT in complex HCM cases.
Abstract:
Dual chamber (DDD) pacing and catheter-based nonsurgical septal reduction therapy (NSRT) with ethanol are evaluated for treatment of patients with hypertrophic cardiomyopathy. This report describes a patient with hypertrophic cardiomyopathy and left ventricular outflow tract obstruction who had failed to respond to DDD pacing but showed benefit from subsequent NSRT. Procedural difficulties during NSRT due to massive septal hypertrophy are presented.