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Cyanoacrylate for septal ablation in hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  20973822     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective:  Alcohol septal ablation (ASA) has been shown to be an effective treatment in patients with hypertrophic obstructive cardiomyopathy (HOCM) who are refractory to medical treatment. We describe an alternative approach for septal ablation with glue (cyanoacrylate), which is particularly useful in patients with the collateral formation to the right coronary artery in whom ASA is contraindicated. Methods:  In our method left coronary ostium was cannulated with 6-8F guiding catheter. Septal branch was cannulated with a 4F catheter and a microcatheter then cyanoacrylate mixture was instilled into the septal artery. Immediate polymerization prevents the leak into the left anterior descending coronary artery, and also into the right coronary artery (RCA) via septal collaterals. Results:  Glue septal ablation (GSA) was performed in 18 patients (6 patients had collateral branches to RCA). Immediately after the procedure peak left ventricular outflow (LVOT) gradient reduced significantly both in cardiac catheterization (65.0 ± 13.8 vs. 14.2 ± 5.7 mmHg, P < 0.001) and Doppler echocardiographic measurements (75.8 ± 19.9 vs. 18.0 ± 9.1 mmHg, P < 0.001). LVOT tract gradient reduction persisted after 6 months follow-up. Septal wall thickness (20.2 ± 3.7 mm vs. 16.5 ± 3.2 mm, P = 0.003) reduced and NYHA functional class (3.1 ± 0.4 vs. 2.2 ± 0.3, P < 0.001) improved. There was no significant complication during the procedure and within 6 months follow-up period. Conclusions:  GSA seems to be an efficient and safe approach to HOCM, especially in patients with the collateral formation. Further experience is needed in order to assess the long-term efficacy and safety of this technique. (J Interven Cardiol 2011;24:77-84).
Authors:
Ali Oto; Kudret Aytemir; Sercan Okutucu; Ergun Baris Kaya; Ali Deniz; Barbaros Cil; Bora Peynircioglu; Giray Kabakci
Publication Detail:
Type:  Journal Article     Date:  2010-10-25
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  24     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-84     Citation Subset:  IM    
Copyright Information:
©2010, Wiley Periodicals, Inc.
Affiliation:
Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Turkey Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey.
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