Myectomy-Like Extended Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

Abstract

Currently, two therapeutic options are available for patients with drug-resistant obstructive hypertrophic cardiomyopathy. While there is a tendency in extended myectomy to perform a larger septal reduction to eliminate left ventricular outflow tract gradient more effectively, there has been a trend in recent years toward using lower dosages of alcohol during alcohol septal ablation (ASA) to reduce the risk of arrhythmic complications. We report a case of a symptomatic patient with severe septal hypertrophy who underwent an extended ASA of three septal branches. This led to a result similar to an extended myectomy with a favorable short-term follow-up.

Keywords

hypertrophic cardiomyopathy - coronary artery - symptomatic

• References

• 1 Gersh BJ, Maron BJ, Bonow RO , et al. 2011 ACCF/AHA guidelines for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011; 124: e783-e831
• 2 Veselka J, Tomašov P, Zemánek D. Long-term effects of varying alcohol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy: a randomized study with a follow-up up to 11 years. Can J Cardiol 2011; 27 (6) 763-767
• 3 Maron BJ, Nishimura RA. Surgical septal myectomy versus alcohol septal ablation: assessing the status of the controversy in 2014. Circulation 2014; 130 (18) 1617-1624
• 4 Veselka J, Krejčí J, Tomašov P , et al. Survival of patients ≤ 50 years of age after alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Can J Cardiol 2014; 30 (6) 634-638