Septal reduction therapy using nonalcohol agent in hypertrophic obstructive cardiomyopathy: Single center experience

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Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter

Published on: June 15, 2015

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Serkan Asil1, Barış Kaya2, Uğur Canpolat2

  • 1Department of Cardiology, Gülhane Education and Research Hospital, Ankara, Turkey.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 6, 2017
PubMed

Insights

Ethylene-vinyl alcohol (EVOH) copolymer is an effective alternative for septal ablation in hypertrophic obstructive cardiomyopathy (HOCM). This therapy significantly reduces symptoms and left ventricular outflow tract (LVOT) gradients, offering a viable option for patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a condition often managed with medication or surgery.
  • Percutaneous septal reduction therapy offers an alternative to surgery for drug-refractory HOCM patients.
  • Nonalcoholic agents, including Ethylene-vinyl alcohol (EVOH) copolymer, are increasingly used for septal ablation.

Purpose of the Study:

  • To evaluate the acute and long-term efficacy of Ethylene-vinyl alcohol (EVOH) copolymer during septal ablation in HOCM patients.
  • To assess the safety profile of EVOH copolymer in this patient population.

Main Methods:

  • A study involving 25 symptomatic HOCM patients undergoing septal ablation with EVOH copolymer.
  • Clinical and laboratory assessments were performed pre- and post-procedure.
  • Follow-up included assessment of left ventricular outflow tract (LVOT) gradient, interventricular septum thickness, and New York Heart Association (NYHA) functional class.

Main Results:

  • Significant reduction in peak LVOT gradient (68 to 20 mmHg) immediately post-procedure.
  • Significant improvement in NYHA functional class and reduction in interventricular septum thickness during 12-month follow-up.
  • Minor complications observed: EVOH embolization in 1 patient (4%) and complete atrioventricular block in 2 patients (8%).

Conclusions:

  • Septal reduction therapy using EVOH copolymer is a safe and effective alternative for symptomatic HOCM.
  • EVOH copolymer effectively reduces LVOT gradient and improves symptoms in HOCM patients.
  • This preliminary study supports EVOH copolymer as a viable therapeutic option for HOCM.
Abstract

Keywords:
EVOHethylene-vinyl alcohol copolymerhypertrophic cardiomyopathyhypertrophic obstructive cardiomyopathyseptal ablationseptal reduction therapy

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