Key result
Alcohol septal ablation successfully reduced the peak left ventricular outflow tract pressure gradient from 108 mmHg to 30 mmHg, with sustained improvement at 3 months.
Why the study?
Does non-surgical septal reduction with absolute alcohol injection reduce LVOT pressure gradient and improve symptoms in a patient with hypertrophic obstructive cardiomyopathy?
Case Report (n=1)
Does non-surgical septal reduction with absolute alcohol injection reduce LVOT pressure gradient and improve symptoms in a patient with hypertrophic obstructive cardiomyopathy?
Alcohol septal ablation successfully reduced the LVOT pressure gradient and improved symptoms in a patient with medically refractory hypertrophic obstructive cardiomyopathy.
Supports feasibility in refractory HOCM; hypothesis-generating pending randomized trials.
Non-surgical reduction of septal myocardial mass was performed with success in a 48-year-old male with hypertrophic obstructive cardiomyopathy. Angioplasty balloon inflated in the first septal branch of the left anterior descending artery dramatically reduced the pressure gradient across the outflow tract of the left ventricle. Following injections of absolute alcohol into the artery with the balloon kept inflated induced a small septal myocardial infarction. By hemodynamic evaluation, the peak pressure gradient of 108 mmHg before the procedure was decreased to 30 mmHg. Clinical improvement in New York Heart Association (NYHA) functional class was obtained. At 3-month follow-up, the patient was doing quite well; the gradient was only 10 mmHg at rest and 25 mmHg with Valsalva maneuver.
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Fusegawa et al. (1999) conducted a case report in Hypertrophic obstructive cardiomyopathy (n=1). Alcohol septal ablation was evaluated on Peak pressure gradient across the left ventricular outflow tract. Alcohol septal ablation successfully reduced the peak left ventricular outflow tract pressure gradient from 108 mmHg to 30 mmHg, with sustained improvement at 3 months.