| Non-surgical myocardial reduction in hypertrophic obstructive cardiomyopathy. | |
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MedLine Citation:
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PMID: 11875998 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Percutaneous transluminal septal ablation was recently introduced as an alternative to surgical treatment of hypertrophic obstructive cardiomyopathy. In this procedure, alcohol is injected into a proximal septal artery to create a localized myocardial infarction. OBJECTIVES: To characterize the immediate and medium-term results following PTSMA. METHODS: Of 13 patients referred for PTSMA, 8 were found suitable for the procedure. Hemodynamic parameters were evaluated prior to and following the procedure, and clinical and echo-Doppler parameters at 2 weeks and 9 months later. RESULTS: The procedure was technically successful in all patients. Resting left ventricular outflow gradient at rest (by Doppler) fell from 82 +/- 37 to 15 +/- 8 mmHg (P < 0.001) 9 months later. Late post-procedural gradient after the Valsalva maneuver was 2 +/- 24 mmHg. The degree of mitral regurgitation fell from 2.0 +/- 0 to 1.5 +/- 0.5 (P < 0.05). New York Heart Association class for dyspnea improved from 2.8 +/- 0.5 to 1.8 +/- 0.8 (P < 0.01) and Canadian Cardiovascular Society class for angina from 2.0 +/- 1.3 to 1.3 +/- 1.2 (P = 0.08). Complete right bundle branch block developed in six patients, temporary complete atrioventricular block in three, and persistent block requiring permanent pacing in one. No flow in the distal left anterior descending coronary artery (presumably due to spilling of alcohol) was seen in one (with development of a small antero-apical infarction) and ventricular fibrillation 2 hours post-procedure in one. None of the patients died. CONCLUSION: PTSMA provided a substantial reduction in left ventricular outflow gradient associated with an improvement in symptomatology. Serious complications are not uncommon. Long-term follow-up is unknown. |
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Authors:
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Diab Mutlak; Luis Gruberg; Shimon Reisner; Walter Markiewicz |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Israel Medical Association journal : IMAJ Volume: 4 ISSN: 1565-1088 ISO Abbreviation: Isr. Med. Assoc. J. Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-03-05 Completed Date: 2002-03-20 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100930740 Medline TA: Isr Med Assoc J Country: Israel |
Other Details:
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Languages: eng Pagination: 86-90 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Rambam Medical Center, Rappoport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angioplasty, Transluminal, Percutaneous Coronary* Cardiomyopathy, Hypertrophic / physiopathology, therapy*, ultrasonography Catheter Ablation* Echocardiography, Doppler Female Hemodynamics / physiology Humans Male Middle Aged Time Factors Treatment Outcome Ventricular Outflow Obstruction / physiopathology, therapy*, ultrasonography Ventricular Remodeling / physiology* |
| Comments/Corrections | |
Comment In:
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Isr Med Assoc J. 2002 Feb;4(2):114-6
[PMID:
11875983
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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