Document Detail


Long-term follow-up after percutaneous septal ablation in hypertrophic obstructive cardiomyopathy.
MedLine Citation:
PMID:  17891517     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to evaluate the longterm follow-up results of percutaneous transluminal septal myocardial ablation (PTSMA) in a large patient cohort. BACKGROUND: PTSMA by alcohol injection into septal branches has shown good acute and short-term results in symptomatic patients with hypertrophic obstructive cardiomyopathy. METHODS: A total of 100 consecutive symptomatic (NYHA class 2.8 +/- 0.6) patients underwent PTSMA. All patients had clinical and non-invasive follow-up at 3 months, 1 year, and annually up to 8 years. RESULTS: One patient died at day 2 after intervention due to fulminant pulmonary embolism following deep venous thrombosis, and eight patients required a permanent DDD-pacemaker due to post-interventional complete heart block. Acute reduction of the left ventricular outflow tract gradient was achieved from 76 +/- 37 to 19 +/- 21 mmHg at rest, from 104 +/- 34 to 43 +/- 31 mmHg during Valsalva maneuver, and from 146 +/- 45 to 59 +/- 42 mmHg post extrasystole (p < 0.0001, each). During follow-up (mean follow-up time: 58 +/- 14 months), three additional patients died (sudden death at 48 months, non-cardiac death at 49 months and stroke-related death at 60 months after the index procedure). All living patients showed clinical improvement to NYHA-class 1.4 +/- 0.6 (after 3 months, n = 99), 1.5 +/- 0.6 (after 1 year, n = 99), and 1.6 +/- 0.7 at final follow-up (n = 96; p < 0.0001, each). Non-invasive follow-up studies documented ongoing outflow tract gradient reduction, decrease of septal and left ventricular posterior wall thickness, and improvement of exercise capacity. CONCLUSIONS: PTSMA is an effective treatment for symptomatic patients with hypertrophic obstructive cardiomyopathy. Follow-up showed ongoing hemodynamic and clinical improvement without increased mortality and morbidity.
Authors:
H Seggewiss; A Rigopoulos; D Welge; P Ziemssen; L Faber
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Publication Detail:
Type:  Journal Article     Date:  2007-09-27
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  96     ISSN:  1861-0684     ISO Abbreviation:  -     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-26     Completed Date:  2008-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  856-63     Citation Subset:  IM    
Affiliation:
Medizinische Klinik 1, Leopoldina-Krankenhaus, Gustav-Adolf-Str. 8, 97422, Schweinfurt, Germany. seggewiss.hubert@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Cardiomyopathy, Hypertrophic / drug therapy*,  physiopathology,  ultrasonography
Chi-Square Distribution
Contrast Media
Echocardiography, Doppler
Ethanol / therapeutic use*
Exercise Test
Female
Follow-Up Studies
Heart Septum / drug effects
Hemodynamics
Humans
Male
Middle Aged
Polysaccharides / diagnostic use
Solvents / therapeutic use*
Survival Analysis
Treatment Outcome
Ventricular Outflow Obstruction / drug therapy*,  physiopathology,  ultrasonography
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Polysaccharides; 0/Solvents; 127279-08-7/SHU 508; 64-17-5/Ethanol
Comments/Corrections
Comment In:
Clin Res Cardiol. 2007 Dec;96(12):851-5   [PMID:  17972006 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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