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Clinical efficacy and safety of alcohol septal ablation for hypertrophic obstructive cardiomyopathy



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Clinical efficacy and safety of alcohol septal ablation for hypertrophic obstructive cardiomyopathy


DENG Dan MENG Jing QU Xiaolong WANG Wenting ZHOU Yang ZHAO Weibo SONG Zhiyuan HU Houyuan

Department of Cardiology, Chongqing Institute of Interventional Cardiology,  Department of Ultrasonography, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China


hypertrophic cardiomyopathy hypertrophic obstructive cardiomyopathy chemical septal ablation real-time three dimensional echocardiography


Objective     To evaluate the clinical efficacy and safety of alcohol septal ablation (ASA) in the treatment of hypertrophic obstructive cardiomyopathy (HOCM).  Methods     Forty-four patients with HOCM undergoing ASA between January, 2001 and January, 2015 were enrolled in this analysis. Catheter technique was used to assess the resting and provoked left ventricular outflow tract gradient (LVOTG) in the patients. Echocardiography was performed at different time points after ASA to assess changes in the resting LVOTG, interventricular septum (IVS), left ventricular ejection fraction (LVEF), mitral regurgitation, left atrial volume (LAV), and left ventricular volume, and the changes of New York Heart Association (NYHA) functional class, and incidence of complications and mortality rate of the patients were recorded after the operation. Results     Catheter measurements showed that both the resting and provoked LVOTG were decreased immediately after ASA from 79.9±37.9 mmHg to 33.8±30.2 mmHg (P<0.01) and from 112.4±43.8 mmHg to 36.8±30.0 mmHg (P<0.01), respectively. β-blocker was prescribed for routine treatment for all patients after ASA. At 6 months after ASA, the patients showed a significant reduction of the left atrial enddiastolic volume from 113.8±50.3 mL to 97.6±45.7 mL (P<0.01) with increased left ventricular volume and improved left ventricular synchronism and NYHA cardiac function. No episodes of complete atrioventricular block, ventricular fibrillation, or sudden cardiac death occurred in these patients after the operation. Conclusion     ASA is safe and effective for treatment of HOCM in patients with suitable first septal perforator artery, and postoperative medication with β-blockers can provide the patients with long-term benefits.


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Last Update: 2017-08-23