CardiomyopathyFollow-Up by Cardiac Magnetic Resonance Imaging in Patients With Hypertrophic Cardiomyopathy Who Underwent Percutaneous Ventricular Septal Ablation
Section snippets
Methods
The study population included 57 patients with symptomatic HC despite optimal medical treatment. The study period was January 2005 to September 2008. All subjects demonstrated a dynamic LV outflow tract (LVOT) pressure gradient of ≥50 mm Hg at rest or 100 mm Hg on provocation. Patients with symptoms limiting daily activities (New York Heart Association or Canadian Cardiovascular Society functional class II or exercise-induced syncope), together with a substantial degree of outflow obstruction,
Results
The baseline characteristics of our patients are listed in Table 1. During the ablation procedure, ethanol was injected in 1 septal artery in 40 patients, 2 septal arteries were ablated in 8 patients, and 3 septal arteries in 3 patients. The mean amount of alcohol injected was 2.6 ± 1.3 ml. The creatine phosphokinase peak was 1,545.4 ± 685.3 U/L, the creatine kinase-MB fraction was 177.9 ± 82.5 U/L, and the lactate dehydrogenase peak was 682.3 ± 246.9 U/L. Two patients (3.8%) developed
Discussion
The range of myocardial infarction size was large (8.5 to 77.7 g). Factors that can influence the infarction size include differences in septal coronary anatomy, position of the inflated balloon within the target artery during ethanol infusion, and the ethanol volume administered. The ethanol volume administered is a very important factor in the PVSA procedure. It has been demonstrated that the amount of alcohol injected can influence the incidence of atrioventricular block.5 With guidance from
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Survival Following Alcohol Septal Ablation or Septal Myectomy for Patients With Obstructive Hypertrophic Cardiomyopathy
2022, Journal of the American College of CardiologyCitation Excerpt :The preference for septal myectomy would be explained to patients who were not suitable for ASA or had comorbidities needing other surgical procedures. Procedural techniques used at each institution have been reported previously.6,10,15-18 All-cause mortality was the primary outcome in the present study, and survival data were obtained through prospectively maintained databases at each center, which, in the United States, were supplemented by LexisNexis Accurint, which links data from a number of sources, including the Social Security Death Master File and state death records.
Short- and long-term outcome after alcohol septal ablation in obstructive hypertrophic cardiomyopathy: Experience of a reference center
2019, Revista Portuguesa de CardiologiaCitation Excerpt :Our results are in agreement with previous series that observed a pacemaker implantation rate of less than 10%.16,17,19 A study with contrast-enhanced cardiac magnetic resonance imaging confirmed that infarct size correlated with alcohol volume and electrocardiographic changes with infarct location.30 Procedure-related complications included one case of cardiac tamponade, one of inferior myocardial infarction and two of vascular access site complications without need for surgical intervention.
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2017, Diagnostic Imaging: PediatricsThe emerging role of cardiovascular MRI for risk stratification in hypertrophic cardiomyopathy
2014, Clinical RadiologyCitation Excerpt :The LGE signal is usually more intense than that seen with typical HCM replacement fibrosis. It should be noted that focal transmural infarction of the basal septum is an expected finding following catheter-directed septal alcohol ablation therapy for LVOT obstruction.57 Almost all patients with HCM have some degree of diastolic dysfunction, which is thought to relate to stiffening and delayed relaxation of the myocardium secondary to increased muscle mass, fibrosis, and abnormal dissociation of muscle filaments during early diastolic filling.58
Alcohol Septal Ablation in Patients with Hypertrophic Obstructive Cardiomyopathy: A Contemporary Perspective
2023, Journal of Clinical Medicine
This study was supported by the Youth Fund from the Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, People's Republic of China.