[Septal alcohol ablation in patients with hypertrophic cardiomyopathy]
Gustavo López-Aburto1, Juan Manuel Palacios-Rodríguez, Samuel Cantú-Ramírez
1Hospital de Cardiología, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, Mexico.
Insights
Alcohol septal ablation effectively treats severe obstructive hypertrophic cardiomyopathy (SOHC), significantly improving symptoms and reducing left ventricular outflow tract gradients. This minimally invasive procedure offers a high success rate with minimal complications for SOHC patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Imaging
Context:
- Septal obstructive hypertrophic cardiomyopathy (SOHC) presents significant clinical challenges.
- Patients often exhibit refractory symptoms and hemodynamic instability.
- Current treatment options may be limited or invasive.
Purpose:
- To evaluate the clinical and hemodynamic outcomes of alcohol septal ablation in patients with SOHC.
- To assess the efficacy and safety of this interventional procedure.
Summary:
- This observational, longitudinal study followed 21 SOHC patients refractory to standard treatment.
- Alcohol septal ablation led to significant improvements in New York Heart Association functional class (from III-IV to I-II) within one year.
- Key hemodynamic improvements included a marked reduction in left ventricular outflow tract gradient and mitral incompetence.
Impact:
- Alcohol septal ablation demonstrates a high success rate in managing SOHC.
- The procedure offers a low complication rate, improving patient quality of life.
- This study supports alcohol septal ablation as a viable therapeutic option for selected SOHC patients.
Objective:
to know the clinical and hemodynamic course in septal obstructive hypertrophic cardiomyopathy (SOHC) after alcohol ablation.
Methods:
this was an observational, longitudinal study, including 21 patients with SOHC with functional class of the New York Heart Association (CF-NYHA) refractory to treatment and/or = 30 mm Hg gradient at rest or = 60 mm Hg provoked, or have systolic anterior motion or mitral incompetence (MI) > grade II by echocardiography.
Results:
average age was 50 ± 16 years, males 38.1 %, females 61.9 %; symptoms: angina 42.9 %, dyspnea 85.7 %, syncope 23.8 %. Pre-ablation CF-NYHA was III and IV in 61.9 %; after a year follow-up all of them were class I-II. Pre-ablation, after and one year later, interventricle septum measures were 22.7 ± 4.9 and 20.7 ± 3.1 mm; left ventricular ejection fraction was 65.5 ± 7 %, 62.2 % ± 6.5 % and 68.7 ± 6.2 %; the output gradient of the left ventricle were 106.9 ± 29.9, 44.6 ± 24.3 and 22.0 ± 5.7 mm Hg. Pre-ablation MI grade-III and IV were 33.3 % and 47.6 %; after a year it was grade-0, 52.4 %, grade-I 28.6 %, grade-II, 19 %. There were no hospital mortality.
Conclusions:
the alcohol septal ablation in SOHC patients had a high success treatment with a low complication rate.
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