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Alcohol septal ablation without myocardial contrast echocardiography for hypertrophic obstructive cardiomyopathy

Noppadol Chamnarnphol1, Treechada Wisaratapong, Sirichai Cheewatanakornkul

  • 1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. cnoppado@hotmail.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|January 20, 2012
PubMed

Insights

Alcohol septal ablation (ASA) effectively treats hypertrophic obstructive cardiomyopathy (HOCM) by targeting the first septal branch. This safe procedure, without myocardial contrast echocardiography (MCE), offers significant symptomatic improvement for HOCM patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) presents significant challenges in medical management.
  • Medically refractory HOCM necessitates alternative treatment strategies for symptom relief.

Purpose of the Study:

  • To evaluate the efficacy and safety of alcohol septal ablation (ASA) using anatomical characteristics of the first septal branch.
  • To assess ASA's effectiveness without myocardial contrast echocardiography (MCE) in HOCM patients.

Main Methods:

  • Retrospective review of 12 HOCM patients undergoing ASA between 2007 and 2010.
  • Selection of the target septal perforator artery based on anatomical features.
  • Assessment of hemodynamic parameters and clinical outcomes pre- and post-procedure.

Main Results:

  • Successful ASA in 12 patients, significantly reducing left ventricular outflow tract (LVOT) pressure gradients.
  • Mean LVOT peak pressure gradient decreased from 92.4 mmHg to 21.6 mmHg.
  • All patients reported substantial symptomatic improvement with transient atrioventricular block in two cases.

Conclusions:

  • The first septal branch is often suitable for ASA in HOCM patients with refractory symptoms.
  • ASA without MCE is a safe and effective therapeutic option for selected HOCM patients.
  • Anatomical selection of the target vessel is a viable approach for successful ASA.
Abstract

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