Key result
Alcohol septal ablation is an effective and minimally invasive alternative to surgical septal myectomy for resolving left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.
Why the study?
Because patient selection and centre experience profoundly affect the success of alcohol septal ablation, the authors sought to summarise current evidence, describe the procedure, and propose a cardiomyopathy team-based approach for clinical practice.
Does percutaneous alcohol septal ablation effectively and safely reduce left ventricular outflow tract obstruction and alleviate symptoms in patients with hypertrophic obstructive cardiomyopathy?
Does percutaneous alcohol septal ablation effectively and safely reduce left ventricular outflow tract obstruction and alleviate symptoms in patients with hypertrophic obstructive cardiomyopathy?
This review summarizes current evidence supporting alcohol septal ablation as a valid, minimally invasive alternative to surgical septal myectomy for symptomatic hypertrophic obstructive cardiomyopathy.
May be considered in select patients; leaves open need for randomized comparisons on long-term outcomes.
Percutaneous alcohol septal ablation (ASA) is an effective and minimally invasive therapeutic strategy to resolve left ventricular outflow tract obstruction (LVOTO) in patients with hypertrophic cardiomyopathy who remain symptomatic on maximally tolerated medical therapy. First performed by Sigwart in 1994, the procedure consists in determining an iatrogenic infarction of the basal interventricular septum to reduce LVOTO and alleviate symptoms. Since its first description, numerous studies have demonstrated its efficacy and safety, proposing ASA as a valid and attractive alternative to surgical septal myectomy. The success rate of the intervention is profoundly affected by patient selection and centre experience. In this review, we sought to summarise current evidence on ASA, describing the procedure and proposing a cardiomyopathy team-based approach to resolve clinical disputes in clinical practice.
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Pelliccia et al. (2019) conducted a review in Hypertrophic obstructive cardiomyopathy. Alcohol septal ablation (ASA) vs. Surgical septal myectomy was evaluated. Alcohol septal ablation is an effective and minimally invasive alternative to surgical septal myectomy for resolving left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.
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