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We consider the results from the ongoing

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<p>This manuscript looks at basic limitations of alcohol septal ablation in obstructive hypertrophic cardiomyopathy. They include high-grade atrioventricular blockages, residual obstructions of the left ventricular outflow tract and the so-called proarrhythmic effects of alcohol septal ablation procedure. All these weaknesses are reviewed in the context of incidence, etiology, and prevention.</p><p>Received 25 February 2017. Accepted 10 April 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: M.G. Kashtanov.<br />Data collection and analysis: M.G. Kashtanov.<br />Drafting the article: M.G. Kashtanov, E.M. Idov.<br />Final approval of the version to be published: M.G. Kashtanov, S.D. Chernyshev, L.V. Kardapoltsev, S.V. Berdnikov, E.M. Idov.</p><p>Full text of the article is in the online version of this paper at <a href="http://dx.doi.org/10.21688/1681-3472-2017-3-12-22">http://dx.doi.org/10.21688/1681-3472-2017-3-12-22</a></p>

Цель. Улучшение результатов лечения при панкреатогенном кровотечении. Материал и методы. Представлены результаты рентгенэндоваскулярного гемостаза у 42 пациентов с кровотечением, источником которого была поджелудочная железа. Причинами кровотечения были осложнения операций на поджелудочной железе у 8 больных, острого панкреатита-у 6, хронического панкреатита-у 27, опухоль поджелудочной железы-у 1 пациента. Желудочно-кишечное кровотечение отмечено у 19 пациентов, в полость постнекротической кисты-у 7, в забрюшинную клетчатку-у 2, в брюшную полость-у 6, в послеоперационную рану-у 2. Комбинированные варианты кровотечения развились у 6 больных. Результаты. Источник кровотечения обнаружен при КТ-ангиографии и прямой селективной ангиографии у всех больных. Эндоваскулярный гемостаз обеспечен также всем больным. Поздний рецидив кровотечения развился у 2 больных, причиной была аррозия сосуда дистальнее установленного армированного стента при сохранившемся кровотоке через коллатерали. Повторным рентгенэндоваскулярным вмешательством в обоих наблюдениях кровотечение остановлено. Заключение. Рентгенэндоваскулярные вмешательства являются эффективным способом остановки панкреатогенного кровотечения. Организация помощи таким пациентам требует их госпитализации в специализированные хирургические центры.

Objectives The objective of this research was to assess the long‐term results of alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy (HOCM), with all of them receiving a standard 3 mL ethanol dose. Background Generally, ethanol (0.5–3 mL) is infused depending on a septal artery width or interventricular septum (IVS) thickness during alcohol septal ablation. We injected 3 mL of ethanol irrespective of IVS thickness or perforator width in all cases. Methods Between 2000 and 2017, 150 HOCM patients (78 males, 72 females) underwent alcohol septal ablation procedures. In all cases we intentionally used the constant dose of ethanol (3 mL). The median of age was 52 (interquartile range: 41–60) years. Results The median of follow‐up was 71 (interquartile range: 36–110) months. Hospital mortality was 0.67% (one patient died of sepsis). Perioperative high‐grade atrioventricular blocks required permanent pacemaker implantations—18 (12%). Long‐term survival rates were as follows: 95.1% (95% confidence interval [CI]: 92.7–97.5%), 85.8% (95% CI: 83.7–87.0%), and 81.7% (95% CI: 79.7–83.7%) at 5‐, 10‐, and 15‐year follow‐up, respectively. One‐sample log‐rank test revealed no significant differences in 15‐year survival rates between the alcohol septal ablation cohort and age‐ and sex‐matched Russian population. Conclusions Alcohol septal ablation with the standard (3 mL) ethanol dose is safe and efficient. Survival rates after alcohol septal ablation are comparable with those in age‐ and sex‐matched general Russian population.

This study looks at 10-year follow-up outcomes of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy.Between 2000 and 2008, 40 patients with obstructive hypertrophic cardiomyopathy (27 males, 13 females) underwent alcohol septal ablation. The median follow-up period was 123 (2–179) months. The mean age ran to 43.8 + 13.9 years. The initial dose of ethanol (3 mL) was chosen for ablation in all cases.The hospital mortality was 0%. Permanent pacemakers were implanted in 3 of 40 (7.5%) cases in the hospital period. The median clinical follow-up was 123 (2–179) months. Survival rates at 1, 5, 10, and 15 years after the procedure were as follows: 97.5% (95% confidence interval [CI], 95.1–99.9%), 92.5% (95% CI, 94.8–90.2%), 85.0% (95% CI, 82.9–87.1%), and 81.3% (95% CI, 79.3–83.3%), respectively. Seven patients died during follow-up. Sudden death was observed in two cases. Permanent pacemakers were implanted in 2 of 40 (5%) cases in the follow-up. The log-rank test revealed no statistically significant difference between the 15-year survival rate in our cohort and age- and sex-matched general Russian population (p = 0.11113).Alcohol septal ablation provides long-term survival rates that look comparable with age- and sex-matched general population in the 15-year follow-up period.

<p>The article looks at some aspects of selecting patients with obstructive hypertrophic cardiomyopathy for alcohol septal ablation (ASA) procedure. Based on the world’s experience and in the context of evidence-based medicine, the current positions of ASA in complex treatment of obstructive hypertrophic cardiomyopathy are described. </p><p>Received 29 September 2016. Accepted 9 January 2017.</p><p><strong>Funding:</strong> The study had no sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p><strong>Author contributions</strong></p><p>Data collection and analysis: Kashtanov M.G. <br />Drafting the article: Kashtanov M.G. <br />Critical revision: Kashtanov M.G., Idov E.M., Chernyshev S.D., Kardapoltsev L.V., Berdnikov S.V.</p>