| Percutaneous transluminal septal myocardial ablation in drug-resistant hypertrophic obstructive cardiomyopathy: 18-month follow-up results. | |
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MedLine Citation:
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PMID: 11435640 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Surgery has been the only therapeutic option in patients with hypertrophic obstructive cardiomyopathy (HOCM) who are resistant to standard treatment. Percutaneous transluminal septal myocardial ablation (PTSMA) by alcohol-induced occlusion of the septal artery for the reduction of left ventricular outflow tract (LVOT) gradient is a novel method. However, long-term clinical follow-up is insufficient. This study reports the acute and mid-term results after PTSMA in symptomatic patients with HOCM. METHODS: Six patients (4 men and 2 women) with symptomatic HOCM and inadequate response to pharmacologic therapy had their major septal branches ablated with alcohol. Mean duration of follow-up was 1.5 years. RESULTS: There was reduction in LVOT gradient in all patients (100%) with a mean reduction of 50 mmHg. Two patients developed complete heart block (CHB) and 3 patients developed bifascicular block. CHB persisted in 1 patient. Two patients died within 8 days of the procedure; one due to cerebrovascular accident and 1 due to asystole. The patient who died of asystole had CHB but refused permanent pacemaker implantation. CHB reverted in 1 patient and bifascicular blocks persisted in 3 patients. Clinical and echocardiographic follow-up was achieved in the 4 surviving patients after 1.5 years. All surviving patients had LVOT gradient reduction and clinical improvement. CONCLUSION: PTSMA for HOCM is a non-surgical technique for reducing LVOT gradient. Heart blocks are one potential complication, and may require pacemaker implantation. Long-term follow-up and a larger series of patients are required to determine conclusive therapeutic significance. |
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Authors:
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A Oomman; P Ramachandran; K Subramanyan; M S Kalarickal; M N Osman |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of invasive cardiology Volume: 13 ISSN: 1042-3931 ISO Abbreviation: J Invasive Cardiol Publication Date: 2001 Jul |
Date Detail:
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Created Date: 2001-07-03 Completed Date: 2001-08-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 526-30 Citation Subset: IM |
Affiliation:
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Apollo Hospitals, Department of Cardiology, Chennai, India. dr-oomman@lycos.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiomyopathy, Hypertrophic / therapy*, ultrasonography Catheter Ablation* Ethanol / therapeutic use* Female Follow-Up Studies Heart Septum / drug effects, ultrasonography Humans Male Middle Aged Ventricular Function, Left / drug effects* |
| Chemical | |
Reg. No./Substance:
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64-17-5/Ethanol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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