What does this research mean for the field?

The Liwen procedure (echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation) can safely relieve left ventricular outflow tract obstruction without recurrent obstruction or arrhythmia at one-year follow-up in patients with hypertrophic obstructive cardiomyopathy. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 5, 2018Echocardiography

Echocardiography Guided Liwen Procedure™ for the treatment of obstructive hypertrophic cardiomyopathy in a patient with prior aortic valve replacement surgery

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Hypertrophic obstructive cardiomyopathy (n=1). Intervention: Liwen procedure (percutaneous intramyocardial septal radiofrequency ablation). Primary outcome: LVOT obstruction or arrhythmia.

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Key result

Liwen procedure relieves LVOT obstruction without arrhythmia at one year in a HOCM case.

Why the study?

Does the Liwen procedure safely and effectively treat LVOT obstruction in a patient with hypertrophic obstructive cardiomyopathy and prior aortic valve replacement?

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Does the Liwen procedure safely and effectively treat LVOT obstruction in a patient with hypertrophic obstructive cardiomyopathy and prior aortic valve replacement?

Population

1 patient with hypertrophic obstructive cardiomyopathy and prior aortic valve replacement surgery, treated with the Liwen procedure and followed for one year.

Intervention

Liwen procedure (percutaneous intramyocardial septal radiofrequency ablation) under transthoracic echo guidance

Outcome

Safety and effectiveness (absence of LVOT obstruction or arrhythmia)

The Liwen procedure (percutaneous intramyocardial septal radiofrequency ablation) may be a safe and effective novel treatment for hypertrophic obstructive cardiomyopathy in patients with prior aortic valve replacement.

Implication

Extends Liwen procedure to post-AVR HOCM; hypothesis-generating and should not yet change practice.

Abstract

We successfully treated a patient who was diagnosed of having hypertrophic obstructive cardiomyopathy after the aortic valve replacement surgery for the concomitant aortic stenosis. We report this first in kind new procedure exclusively developed in our center, Liwen procedureTM (percutaneous intramyocardial septal radiofrequency ablation), for patients with left ventricular outflow tract obstruction in spite of maximal medical therapy. The procedure was performed under transthoracic echo guidance. We discussed the technical details, safety, and effectiveness with corresponding images. The patient did well one year after the procedure without LVOT obstruction or arrhythmia.

Discussion

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Cite This Study

Liu et al. (2018) conducted a case report in Hypertrophic obstructive cardiomyopathy (n=1). Liwen procedure (percutaneous intramyocardial septal radiofrequency ablation) was evaluated on LVOT obstruction or arrhythmia. The Liwen procedure (percutaneous intramyocardial septal radiofrequency ablation) was successfully performed in a patient with hypertrophic obstructive cardiomyopathy, who remained free of LVOT obstruction or arrhythmia at one year.

synapsesocial.com/papers/6aa51032f197b883c13d6a3b https://doi.org/10.1111/echo.14040