Document Detail

Rescue alcohol septal ablation in sepsis with multiorgan failure.
MedLine Citation:
PMID:  23253412     Owner:  NLM     Status:  MEDLINE    
A 55 year old male patient with a diagnosis of hypertrophic cardiomyopathy was admitted with features of sepsis related to cholangitis. Initial management with intravenous (i.v.) fluids and antibiotics did not cause any change in his general condition mandating an emergency endoscopic retrograde cholangio-pancreatography (ERCP). After successful retrieval of CBD stone on ERCP, patient had massive upper gastrointestinal bleed leading to hypotension and shock. Addition of inotropes had led to further deterioration in his clinical status with a mean arterial BP falling to 44 mm of Hg. His echocardiography showed a resting left ventricular outflow tract (LVOT) gradient of 90 mm of Hg and thus was taken up for emergency alcohol septal ablation (ASA). Immediately after ASA, patient had significant decrease in LVOT obstruction and rise of systemic arterial pressures. After 10 days of antibiotic therapy patient was discharged with a residual LVOT obstruction of 28 mm of Hg.
Parag W Barwad; S Ramakrishnan; Sandeep Seth; Balram Bhargava
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-09-13
Journal Detail:
Title:  Indian heart journal     Volume:  64     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-12-20     Completed Date:  2013-07-12     Revised Date:  2014-01-23    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  India    
Other Details:
Languages:  eng     Pagination:  588-90     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
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MeSH Terms
Ablation Techniques / methods*
Anti-Bacterial Agents / therapeutic use
Cardiomyopathy, Hypertrophic / drug therapy*
Cholangiopancreatography, Endoscopic Retrograde / adverse effects*
Cholangitis / complications*,  surgery
Ethanol / therapeutic use*
Gastrointestinal Hemorrhage / etiology*,  therapy*
Heart Septum / drug effects
Middle Aged
Multiple Organ Failure / etiology*
Sepsis / etiology*
Ventricular Outflow Obstruction / drug therapy*,  etiology*
Reg. No./Substance:
0/Anti-Bacterial Agents; 3K9958V90M/Ethanol

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

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